Complications following body contouring surgery after massive weight loss: a meta-analysis

Bariatric surgery is a way to achieve lasting weight loss in the obese. Body contouring surgery seeks to alleviate some of the discomfort caused by the excessive loose skin following massive weight loss. Higher complication rates are described in this type of surgery when done post-bariatric. The purpose of this article is to compare complication rates of body contouring surgery when performed on patients with weight loss due to bariatric surgery compared to patients who lost weight due to dietary changes and/or exercise.

A total of 253 studies were identified by searches in PubMed/Medline databases as well as two hand-search strategies. Three levels of screening resulted in seven studies being considered suitable for inclusion in the meta-analysis. All statistical calculations were performed with Review Manager (RevMan) Version 5.2.3.

The fixed-effects pooled risk ratio (RR) of developing complications after body contouring surgery when comparing post-bariatric and non-bariatric patients is 1.60 (95% confidence interval (CI) 1.30-1.96; P < 0.00001; I(2) = 48%) showing that there is a 60% increase in the risk of developing complications if the patient lost weight due to surgery. A subgroup analysis of studies with patients only having one body contouring procedure shows an 87% higher increase in the risk of developing a complication when being post-bariatric (RR = 1.87; 95% CI 1.46-2.40; P < 0.00001; I(2) = 0%). If we exclusively look at the studies with a less uniform patient population that included patients who had one procedure performed as well as patients who had several procedures performed, there seems to be a non-significant 4% lower risk of developing a complication in the case of post-bariatric patients compared to the non-bariatric patients (RR = 0.96; 95% CI 0.65-1.42; P = 0.84; I(2) = 0%).

The analysis shows a 60-87% increased risk of complications in the post-bariatric group compared to the non-bariatric group with statistical significance.