A tummy tuck (tummy tuck) provides great patient satisfaction and an improved quality of life in overweight or obese patients – despite the risk of complications important.
An “Overwhelming Majority” of Obese or Overweight Patients Are Satisfied with the Results of a Tummy Tuck, according to the study by Dennis C. Hammond, MD, and his colleagues from Partners in Plastic Surgery in Grand Rapids, West Michigan. They write: “Real improvement in quality of life can be achieved by offering body shaping even in the face of obesity, while keeping in mind that the risk of minor postoperative complications is high.”
The risks are higher, but body shaping has real advantages for patients with increased BMI
Abdominoplasty is an effective procedure to improve the appearance of the abdomen. However, this procedure and other body contouring procedures have always been discouraged in overweight or obese patients. This reflects the fear that an increase in body mass index (BMI) may increase the risk of wound healing problems and other complications.
The researchers analyzed the results of abdominoplasty surgery in 46 overweight / obese patients over a 12-year period. The patients were 41 women and five men, aged 49 years on average. All had a BMI of 25 or more, with an average BMI of 32. (A BMI of 25 or more is considered overweight, while a BMI of 30 is the threshold for obesity.)
Eighty percent of patients underwent an abdominoplasty, most often including a procedure to restore weakened or separated abdominal muscles. The remaining 20 percent had a procedure called panniculectomy to remove excess, “hanging” fat from the abdomen and skin. The researchers analyzed the results of the surgery, including the rates of complications and the results assessed by the patient.
Almost half of the patients had some type of complication. About 39% had minor complications, requiring office procedures or antibiotics. About nine percent of patients had major complications requiring return to the operating room, mainly due to problems with wound healing and / or fluid recovery.
Thirty-six patients participated in follow-up surveys on average 15 months after their intervention. Ninety-four percent of patients were satisfied with the results of the tummy tuck / panniculectomy, while 97% said they would choose to have the procedure done again. Ninety-seven percent of patients said the procedure had improved their quality of life. Almost half of the patients reported losing weight after surgery.
“Abdominoplasty and panniculectomy in the obese or obese patient presents itself as a decisional challenge for the treating surgeon”, writes Dr. Hammond. Due to their increased risk of complications, patients are generally advised to lose weight before undergoing body contouring surgery.
The researchers noted that “even with weight loss, excess skin and fat… will not disappear completely and may still be an obstacle to normal functioning and exercise. ” While recognizing the increased risks, they have offered a tummy tuck or panniculectomy to obese or overweight patients “in order to relieve the discomfort and physical effects of excess skin and fat and to offer the potential to relaunch a weight loss process ”.
The authors believe that their results support this strategy. Although complications are common, most were minor and manageable, and many patients lost more weight after surgery. Dr. Hammond and colleagues conclude: “With this high complication rate, the patient satisfaction rate is extremely high, making body contouring procedures in this patient population an acceptable option for appropriately selected patients. . ”