A tummy tuck (tummy tuck) provides great patient satisfaction and improved quality of life in overweight or obese patients – despite a 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, et al. colleagues at Partners in Plastic Surgery in Grand Rapids, West Michigan. They write: “Real improvement in quality of life can be achieved by providing body sculpting even in the face of obesity, bearing in mind that the risk of minor postoperative complications is high.”
Risks are higher, but body contouring has real benefits for patients with increased BMI [19459011 ]
Abdominoplasty is an effective procedure for improving the appearance of the abdomen. However, this 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) increases the risk of problems with wound healing and other complications.
Researchers analyzed the results of tummy tuck surgery in 46 overweight / obese patients over a 12-year period. The patients were 41 women and five men, with an average age of 49 years. 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 tummy tuck surgery, most often including a procedure to restore weakened or separated abdominal muscles. The remaining 20 percent had a procedure called panniculectomy to remove the excess, “suspension” of belly fat and skin. The researchers analyzed the results of the surgery, including complication rates and patient-rated outcomes.
Almost half of the patients had some type of complication. About 39% had minor complications, requiring office procedures or antibiotics. About nine percent of the patients presented with major complications requiring return to the operating room, primarily due to problems with wound healing and / or fluid recovery.
Thirty-six patients participated in follow-up surveys an average of 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 again. Ninety-seven percent of patients said the procedure 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 decision-making challenge for the attending surgeon,” writes Dr. Hammond. Because of their increased risk of complications, patients are generally advised to lose weight before having body contouring surgery.
The researchers noted that “even with weight loss, the excess skin and fat… will not completely disappear and may still be an obstacle to normal functioning. and exercise. ” While recognizing the increased risks, they offered tummy tuck or panniculectomy to obese or overweight patients “with the aim of relieving the discomfort and physical effects of excess skin and fat and offering the potential to restart a weight loss process ”.
The authors believe their findings support this strategy. Although complications were common, most were minor and easily managed, and many patients lost more weight after surgery. Dr Hammond and colleagues conclude: “With this high complication rate, patient satisfaction is extremely high, making body contouring procedures for this patient population an acceptable option for appropriately selected patients. . ”