Predictors of satisfaction with excess skin and desire for body contouring after bariatric surgery

Background: Bariatric surgery (BS) produces rapid, massive weight loss, often leaving patients with excess skin that can be esthetically disappointing and can present barriers to physical and psychosocial functioning. Thus, body contouring surgery (BCS) is frequently sought by post-BS patients. The objectives of the present study were to characterize the frequency at which post-BS patients desire BCS and the extent to which patients are satisfied with the excess skin in specific body regions before and after contouring. Furthermore, the present study sought to identify the predictors of which patients might be most desirous of BCS. This was a study conducted at 2 academic research centers. Methods: Patients approximately 2 years or 6-10 years after BS were recruited and completed the Post-Bariatric Surgery Appearance Questionnaire. Results: The participants expressed the greatest dissatisfaction with the skin at the waist/abdomen and thigh regions. The most commonly contoured site was the waist/abdomen, and patients rated greater satisfaction with this body region after BCS. Few significant predictor variables were identified. A greater BMI at survey completion was independently associated with lower satisfaction with excess skin, and the time elapsed since BS predicted the desire for contouring. Conclusion: These findings underscore the importance of educating BS candidates about the issues with redundant skin after weight loss and the possible need for subsequent BCS. With this education, patients might have more realistic expectations concerning BS outcomes and be better positioned to seek BCS when indicated. (Surg Obes Relat Dis 2012;8:92-97.) (C) 2012 American Society for Metabolic and Bariatric Surgery. All rights reserved.