Changes in quality of life and functional status following abdominal contouring in the massive weight loss population.

BACKGROUND: Abdominal contouring surgery is commonly performed following massive weight loss. Outcome data following abdominal contouring have been reported regarding body image and symptoms in general; however, few data exist regarding specific functional improvements. The authors examined functional changes in quality of life following abdominal contouring in the massive weight loss population.

METHODS: Fifty-two consecutive patients were reviewed from the authors' prospective database. Outcome measures included body mass indices, comorbidities, resection weight, and 24 functional variables. Outcome measures were assessed by univariate and multivariate analysis.

RESULTS: Forty-nine patients completed the survey (94 percent). Average patient age was 45.8 years at the time of surgery (range, 25 to 68 years). Mean maximum body mass index was 56.1 ± 11.8 kg/m2, mean pre-body contour body mass index was 34.6 ± 10.1 kg/m2, mean pre-body contour change in body mass index was 21.4 ± 6.9 kg/m2, mean post-body contour body mass index was 32.4 ± 9.3 kg/m2, and mean post-body contour change in body mass index was 2.1 ± 2.9 kg/m2. Statistically significant improvements in all functional outcomes were appreciated, except shoulder pain. Rectus plication did not significantly improve functional outcomes. Higher maximum and pre-body contour body mass index values were significantly related to greater improvement in functional outcomes (p < 0.05); 91.8 percent of patients said they would undergo abdominal contouring again or would recommend it to a friend.

CONCLUSIONS: Abdominal contouring surgery improves functional status of massive weight loss patients, especially those with a higher body mass index at the time of surgery. Rectus plication did not influence functional outcomes. Prospective functional assessments may aid in optimizing outcomes in the management of the massive weight loss patient.

CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, IV.