Current concepts in post-bariatric body contouring

The advent of bariatric surgery has led to a new subspecialty in plastic surgery for contouring the skin and fat remaining after massive weight loss. This field is increasingly recognized as a vital component to the multi-disciplinary treatment approach to care for the obese patient. The author sought to review key concepts in patient selection, technical advancements, and post-operative care in body contouring following weight loss surgery.

A literature review in PubMed identified articles relevant to the care of massive weight loss patients presenting for plastic surgical contouring. These articles were combined with a retrospective review of the author's personal experience in management of these patients.

The best candidates for post-bariatric plastic surgery are those who have achieved weight loss stability with a BMI of 35 or less and who have adequate nutrition to heal the surgical excisions. Truncal deformity is the most common presenting complaint of massive weight loss patients, and the procedure of choice to address this region is a lower body lift. Post-operative care focuses on patient safety prioritizing in DVT prophylaxis and seroma prevention.

Bariatric procedures routinely achieve sustained decreases in body mass index; however, the remaining skin in the massive-weight-loss patient serves as a reminder of their previous obese existence. Post-bariatric body contouring aims to correct this deformity and restore a sense of normalcy. By reshaping the body into its ideal proportions, the true success of the weight loss surgery is fully realized.