Outcomes of Abdominal Contouring in Patients With and Without Weight Loss Surgery: A Propensity-Matched Comparison Study.

Background: Patients undergo abdominoplasty/panniculectomy following excessive weight loss and/or to improve abdominal appearance/shape. The authors aim to compare clinical outcomes and quality of life (QoL) following these procedures in patients with/without a history of weight loss surgery (WLS).

Methods: A single-center, single-surgeon retrospective review from 2015-2022 was performed examining patients who underwent abdominal contouring procedures with/without a history of WLS. A propensity-scored match was performed based on age and gender. Surgical outcomes and patient reported outcomes (BODY-Q) were compared.

Results: Overall, 208 patients (104 per group) were identified (mean follow-up:15.5±14.2 months). Mean age was 47.4±11.0 years, and majority female (86.1%). WLS group had greater BMI (35.4±9.3 vs. 29.7±6.9 kg/m2, p<0.05), tissue excised (1,680.3±1003.7 vs 976.1±630.9 cm2, p<0.05), and were more likely approved by insurance (85.1% vs 39.8%, p<0.05). Liposuction was more frequently performed in non-WLS patients (51.9% vs. 11.5%, p< 0.05). WLS patients experienced greater rates of delayed wound healing (34.6% vs. 16.5%, p<0.05); there were no predictive factors on multivariate regression. There were no differences in surgical site infections, hematomas, cellulitis, cosmetic outcomes, readmissions/revisions (p>0.05). WLS patients demonstrated significant improvement in QoL: appraisal, body image, physical function, and sexual function (p<0.05).

Conclusion: Patients with a history of WLS undergoing abdominal contouring procedures experience increased wound healing complications compared to non-WLS patients. Major complications requiring reoperation/revision were no different between groups. All patients had significant QoL gains in body and abdominal satisfaction, psychological function, psychosocial function, and appraisal. WLS patients had additional improvements in body image, physical, and sexual function.