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With body contouring, size matters

Article-With body contouring, size matters

Orlando, Fla. — Preoperative weight is the single most important factor to predict the long-term result of body contouring surgery procedures, according to a recent study by Ran Talisman, M.D., director and chief surgeon, The Aesthetic Center, Tel Aviv, Israel, and his colleagues.

Studying the study

Dr. Talisman set out to refine the selection criteria of the best candidates for body contouring surgery.

Dr. Talisman
Between 1998 and 2003, 1,173 female patients underwent liposuction, dermolipectomy or combined procedures by the surgeons. Sixty-three patients (5 percent) had dermolipectomy procedures only, 171 patients (15 percent) had a combination of dermolipectomy and liposuction and 939 patients (80 percent) had liposuction only.

Patient charts as well as telephone questionnaires (as needed) were reviewed to study the long-term results and satisfaction.

"The patient data included history of recent weight and weight course, body mass index (BMI), dietary habits, pre-operative weight on the surgery date and finally satisfaction and result maintenance two years after surgery," Dr. Talisman explains.

Out of 1,173 patients, 365 entered the study. The rest were excluded either due to poor follow-up or because their BMI was less than 27.5 although the weight was above 75 kg.

The preoperative weight ranged from 49 kg up to 128 kg and the patients were divided into groups based on the preoperative weight.

  • Group I included 142 patients who weighed less than 55 kg.
  • Group II included 78 patients who were more than 75 kg.
  • Group III included 28 patients that were more than 100 kg.
  • Group IV included 117 patients who were between 55 kg to 75 kg.

And the winner is...

In Group I, 130 patients (92 percent) were satisfied and results were maintained two years post-surgery.

In Group III, only three patients maintained the results (11 percent). In Group II, 49 patients (63 percent) reported satisfaction or results maintaining, although all had weight fluctuation of 2 kg to 6 kg postoperatively.

"In Group IV, there were many subdivisions, but two clinical impressions were noted. One is that the closer in weight to 75 kg the higher the dissatisfaction of the results as the years go by. The other clinical impression is that, if the recent weight is in the decreasing direction the chances to maintain results are higher," Dr. Talisman says.

Dr. Talisman and his colleagues concluded that the majority of patients with normal BMI will maintain and enjoy the results of body contouring surgery. However, for patients who are obese with BMI more than 38, the chances to maintain results are practically zero.

"We recommend performing surgery on patients with normal to slightly overweight BMI or, in case of overweight patients, to select only those who are in active weight loss programs in order to achieve a long-term high satisfaction rate," he says, noting that further study on biochemistry and hormone activity should be investigated to better understand the postoperative course in overweight patients.

"Long-term, good and stable results are our goal in any surgical procedure and especially in the body contouring field. We who perform the surgery know that it is not always a success. My feeling was that the weight is the only easy measurable factor (or signal) that tells me what the chances are for the future success in a particular patient."

Formula for failure

"It was our impression before the study, and it is very clear now, that patients who are significantly overweight and who will not attempt to control the weight have a high chance for failure," he says.

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