Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2020 Jul 30:11:459.
doi: 10.3389/fendo.2020.00459. eCollection 2020.

The Impact of Post-bariatric Abdominoplasty on Secondary Weight Regain After Roux-en-Y Gastric Bypass

Jorunn Sandvik  1   2   3 , Torstein Hole  1   4 , Christian Klöckner  2   5 , Bård Kulseng  2   3 , Arne Wibe  6   7
Affiliations

The Impact of Post-bariatric Abdominoplasty on Secondary Weight Regain After Roux-en-Y Gastric Bypass

Jorunn Sandvik et al. Front Endocrinol (Lausanne). .

Abstract

Roux-en-Y gastric bypass (RYGB), implies a considerable weight loss during the first two years after surgery. Excess skin due to rapid weight loss might affect self-esteem, decrease quality of life and be a hindrance to physical activity. Removing excess skin might reduce secondary weight regain. Among plastic surgeons, a BMI <30 kg/m2 is usually required to have abdominoplasty (AP). Many RYGB patients never reach this threshold even if they have a considerable weight loss and experience practical as well as emotional problems due to excess skin. The aim of this study was to investigate the role of abominoplasty on weight development until five years, among patients who did and did not achieve a nadir BMI <30 kg/m2 during the first two years after RYGB. Data on 645 patients from a single center RYGB-quality register from 2004 to 2013 with baseline and follow-up data were analyzed. Post-bariatric AP was publicly funded if medically needed. Weight regain (WR) from nadir weight to five years was analyzed as percentage WR of maximal weight loss. Nadir BMI was available in 633 (98.1%) patients, and BMI after five years in 553 (85.7%) patients. The 233 patients with nadir BMI <30 kg/m2 who underwent AP regained 17.8 (±16.1) % of their maximal weight loss at five years compared to 24.2 (±19.7) % in 185 patients not having AP (p < 0.001). The 27 patients with nadir BMI > 30 kg/m2 within two years after RYGB who underwent AP regained 12.9 (±19.3) % compared to 31.4 (±24.7) % in 188 patients without AP (p < 0.001). This procedure was more common among women than men, as 224 (46.4%) women, and 36 (22.2%) men underwent AP. Abdominoplasty was associated with reduced secondary weight regain after RYGB in this study. Whether this is caused by increased bodily satisfaction and better physical function, or a biological response to reduction of adipose tissue remains unclear. If removing abdominal subcutaneous adipose tissue prevent secondary weight regain and increase the robustness of bariatric surgery, this should be offered as part of the standard treatment after bariatric surgery.

Keywords: bariatric surgery; gastric bypass (RYGB); post-bariatric abdominoplasty; post-bariatric body contouring; post-bariatric weight regain.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Changes in mean BMI from baseline to 5 years after RYGB in patients with and without abdominoplasty and Nadir BMI above or below 30 kg/m2.
Figure 2
Figure 2
Secondary weight regain from nadir to 5 years after Roux-en-Y gastric bypass in percent of maximal weight loss from surgery to nadir weight. The number of patients who underwent abdominoplasty was 233 out of 418 patients with nadir BMI <30 kg/m2, and 27 out of 215 patients with BMI > 30 kg/m2.
Figure 3
Figure 3
Changes in mean BMI from baseline until 5 years after RYGB in men and women with and without abdominoplasty.
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

References

    1. Angrisani L, Santonicola A, Iovino P, Vitiello A, Higa K, Himpens J, et al. . IFSO worldwide survey 2016: primary, endoluminal, and revisional procedures. Obes Surg. (2018) 28:3783–94. 10.1007/s11695-018-3450-2 - DOI - PubMed
    1. Welbourn R, Hollyman M, Kinsman R, Dixon J, Liem R, Ottosson J, et al. . Bariatric surgery worldwide: baseline demographic description and one-year outcomes from the fourth IFSO global registry report 2018. Obes Surg. (2018). 10.1007/s11695-018-3593-1 - DOI - PubMed
    1. Keith CJ, Jr, Gullick AA, Feng K, Richman J, Stahl R, Grams J. Predictive factors of weight regain following laparoscopic Roux-en-Y gastric bypass. Surg Endosc. (2018) 32:2232–8. 10.1007/s00464-017-5913-2 - DOI - PubMed
    1. Karmali S, Brar B, Shi X, Sharma AM, de Gara C, Birch DW. Weight recidivism post-bariatric surgery: a systematic review. Obes Surg. (2013) 23:1922–33. 10.1007/s11695-013-1070-4 - DOI - PubMed
    1. Froylich D, Corcelles R, Daigle CR, Aminian A, Isakov R, Schauer PR, et al. . Weight loss is higher among patients who undergo body contouring procedures after bariatric surgery. Surg Obes Relat Dis. (2016) 12:1731–6. 10.1016/j.soard.2015.09.009 - DOI - PubMed

Publication types