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Factors That Influence Abdominal Contour Deformities After Massive Weight Loss: A Review of 1006 Cases

Lauren L. Zammerilla, BS, Richard H. Zou, BS, Zachary M. Dong, BA, Daniel G. Winger, MS, J. Peter Rubin, MD, Jeffrey A. Gusenoff, MD
University of Pittsburgh Medical Center, Pittsburgh, PA
2014-03-15

Presenter: Lauren L. Zammerilla, BS.

Affidavit:
This research is novel, represents the combined work of all the co-authors, and has not been previously presented. The first author of the paper worked with the co-authors in developing the project, and performed the data collection, analysis, and write-up of the findings.

Director Name: Joseph E. Losee, MD

Author Category: Medical Student
Presentation Category: Clinical
Abstract Category: Aesthetics

Background: Abdominal contour deformities after massive weight loss (MWL) are highly variable, ranging from a mild upper protuberance to multiple rolls. Factors that influence deformity severity are not well established, but knowledge of such factors could aid patients undergoing weight loss.

Methods: All MWL patients presenting for abdominal contouring from 2002-2012 were reviewed, and abdomens were graded using a modified Pittsburgh Rating Scale. Variables analyzed for each patient included BMI indices, type of weight loss surgery, time from weight loss surgery to body contouring consultation and surgery, and body contouring technique.

Results: 1006 patients were evaluated with a mean age of 44.2 years±10.5 years. The mean MaximumBMI was 51.7 kg/m2±9.6 kg/m2, mean CurrentBMI was 30.0 kg/m2±6.4 kg/m2, and mean DeltaBMI was 21.7 kg/m2±7.0 kg/m2. 64% had a high-grade deformity with multiple rolls. 86% had a history of bariatric surgery. Patients with larger DeltaBMIs after MWL had significantly higher deformity grades (p < 0.001). Neither time to consultation (p = 0.964) nor time to surgery (p = 0.635) was related to deformity grade. Type of bariatric procedure (bypass or banding) did not affect deformity grade (p = 0.501). History of bariatric surgery in general was associated with a higher deformity grade (p < 0.001).

Conclusions: Most patients presenting for body contouring after MWL have high-grade abdominal deformities with multiple rolls. Patients interested in MWL should be counseled that their need for plastic surgery may be directly related to their change in BMI and that the best contours often require cosmetic procedures.

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