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Counseling the MWL patient for corrective surgery

Article-Counseling the MWL patient for corrective surgery

Massive weight loss (MWL) leaves behind abdominal contour deformities that can range from a mild protuberance to multiple rolls. Correcting these deformities is often challenging and may require advanced surgical techniques. A new study has evaluated the incidence of patients presenting with various abdominal deformities, as well as the factors influencing those deformities, to better council MWL patients considering corrective surgery.

A research team headed by J. Peter Rubin, M.D., of the University of Pittsburgh Medical Center, reviewed the cases of more than 1,000 MWL patients, with a mean age of just over 44, who presented for abdominal contouring from 2002 to 2012. The researchers graded abdomens using a modified Pittsburgh Rating Scale. Data collected for each patient included body mass index (BMI), history of bariatric surgery and type of contouring surgery.

Results included the following:

  • Mean maximum BMI was 51.7 ± 9.6 kg/m2, with the mean current BMI index at 30 ± 6.4 kg/m2
  • Mean BMI change was 21.7 ± 7 kg/m2
  • About two-thirds of the patients had a high-grade deformity
  • Patients with a larger BMI change had higher deformity grades, and patients with higher deformity grades were more likely to undergo a fleur-de-lis abdominoplasty

The authors conclude that change in BMI positively correlates with deformity grade and more aggressive contouring procedures. “Patients interested in massive weight loss should be counseled that, depending on desire for eventual outcomes, more complex procedures may be required to correct the resultant abdominal deformity,” the authors write.

The study appears in the December 2014 issue of Plastic and Reconstructive Surgery.

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