Body Contouring Surgery Improves Weight Loss after Bariatric Surgery: A Systematic Review and Meta-Analysis
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ORIGINAL ARTICLE
BODY CONTOURING
Body Contouring Surgery Improves Weight Loss after Bariatric Surgery: A Systematic Review and Meta-Analysis Rawan ElAbd1 • Osama A. Samargandi3,4 • Khalifa AlGhanim2 • Salma Alhamad2 Sulaiman Almazeedi2 • Jason Williams3 • Salman AlSabah1,2 • Sarah AlYouha2
•
Received: 6 August 2020 / Accepted: 11 October 2020 Ó Springer Science+Business Media, LLC, part of Springer Nature and International Society of Aesthetic Plastic Surgery 2020
Abstract Introduction Our main objective is to evaluate the effect of body contouring surgery (BCS) on the magnitude and durability of weight loss after bariatric surgery. Methods Medline, EMBASE, Cochrane, and Scopus search were conducted from the time of their inception to June 2020. We included comparative studies that assessed weight progression, in terms of Body Mass Index change (DBMI), Total Body Weight Loss (TBWL%), and Excess Weight Loss (%EWL) for the post-bariatric patient population and the effect of BCS on weight progression. Results Eleven articles were included. The pooled sample size was 2307, of which 691 were cases who underwent BCS post-bariatric surgery, and 1616 were comparative controls. The mean follow-up time for cases and controls were 61.6 ± 23.8 months and 52.2 ± 23.8 months, respectively. Nine studies reported results of BMI changes, six provided %EWL, and five used %TBWL. Significant improvement in weight loss was observed in the BCS group when measured by either DBMI (3 kg/m2 points decrease, p 0.023), %TBWL (6% increase, P \ 0.0001), or %EWL (14% increase, P \ 0.0001). Sub-group analysis
& Osama A. Samargandi [email protected] 1
Department of Surgery, Faculty of Medicine, Kuwait University, Kuwait city, Kuwait
2
Department of Surgery, Jaber Al-Ahmed Hospital, Kuwait city, Kuwait
3
Division of Plastic Surgery, Faculty of Medicine, Dalhousie University, Room 4447, Halifax Infirmary, 4th Floor, Plastic Surgery, 1796 Summer Street, Halifax, NS B3H 3A7, Canada
4
Division of Plastic Surgery, Department of Surgery, King Abdulaziz University, Jeddah, Saudi Arabia
showed that increased follow-up time was associated with higher TBWL% (p 0.02). Conclusion The evidence provided in this review strongly supports the added long-term benefits of body contouring surgery for selected patients after massive weight loss following bariatric surgery. Having a multidisciplinary team that involves a bariatric and a plastic surgeon as well as nutritionists and psychologists for the management of patients with obesity going through the bariatric pathway is recommended. Level of Evidence III This journal requires that authors assign a level of evidence to each article. For a full description of these evidence-based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 Keywords Body contouring surgery Weight loss Bariatric surgery Abdominoplasty Brachioplasty Thigh lift
Introduction Morbid obesity is a growing health concern worldwide [1] that has led to a parallel
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