A long term patient study carried out at theUtrecht University and St. Antonius Hospital in the Netherlands, reported long lasting improved quality of life after body contouring following bariatric surgery. The Study which was based on the patients’ survey was published in the November, 2012 issue of Plastic and Reconstructive Surgery.
Bariatric surgery is usually carried out on morbidly obese patients with BMI 40 or above and with BMI 35 or above in the cases of patients suffering from diseases due to obesity. The surgery is performed to bring in massive weight loss to protect the patients from life threatening diseases and improving quality of life. But in nearly all cases of such surgery, the patients are left with excessive overstretched loose skins which are unable to adjust to the new body after the massive weight loss.
These loose skins create a new set of physical and aesthetic challenges for the patients. Body contouring procedures are then performed to take care of these problems.
Two features of bariatric surgery followed by body contouring procedure stand out.
One is the long time period required to go through the two procedures – it may take about 18 months to complete a bariatric surgery process including preparing the patient for the procedure and to secure the final results of the surgery with the body achieving a stable weight. Body contouring can only be started after the body weight has stabilized and often it is to be done in phases to cover the loose skins in the different body parts. The results of body contouring would also take about 18 months from the start to emerge, thus taking the total time taken to about 36 months or three years which make these procedures long drawn out processes.
The other feature is the tenacity and courage which the patients display to commit themselves not only to the long drawn procedures but also to a disciplined remaining life time of healthy diet and exercise, a necessity to stay well and enjoy the fruits of the two surgeries.
Because of these features and other reasons including the high costs involved in these procedures, it is important to know if the patients do gain improved quality of life compared to pre- procedure stages. The best way to do this is the long term survey of the patients themselves.
In the present case, the survey assessed quality of life (QOL) for 33 post bariatric surgery patients at 4 year and 7 year time lines after their body contouring procedures and also, retrospectively, before the body contouring. The 33 candidates came off a group of 465 patients who went through bariatric surgeries in Netherlands between 1995 and 2005. In 2007, the patients reported their QOL at mean 4 year time line after body contouring. They were again invited to report their QOL three years later.
For measuring QOL, “ 31 items of the Obesity Psychosocial State Questionnaire were used in seven domains- physical functioning (six items), mental well-being (four items), physical appearance (11 items), social acceptance (three items), self-efficacy toward eating and weight control (one item), intimacy (four items), and social network (two items).”
The results of the survey have been discussed and meticulously presented in the published study. Anyone interested in getting detailed information would do well to refer to the study.
However, in summary it may be stated that the patients found at a mean follow up time of 7 years after body contouring (post bariatric surgery) that the Quality of Life (QOL) in six out of seven domains significantly improved compared to their assessment of the preoperative QOL. On the other hand, the patients’ responses also showed a “trivial to small “ reduction in QOL from 4 to 7 years after body contouring which could be attributed to weight regain by some patients and a few other reasons. These reasons could be the patients getting accustomed to the benefits achieved and the patients’ expectations of the surgery results being more than the reality.
The survey was able show that the bariatric surgery followed by body contouring could indeed be a valuable tool in improving the Quality of Life of morbidly obese patients, provided, of course, the patients were suitably advised and guided beforehand by the surgeons to have detailed and realistic expectations from such procedures.
[This write up has derived some information from the article http://cosmeticsurgerytimes.modernmedicine.com/cosmeticsurgerytimes/article/articleDetail.jsp?id=798676&sk=1a4534fedaa98941502c594ec5d8f1bf]