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Surg Obes Relat Dis. 2018 Nov;14(11):1740-1747. doi: 10.1016/j.soard.2018.07.025. Epub 2018 Jul 31.

Psychosocial functioning and quality of life in patients with loose redundant skin 4 to 5 years after bariatric surgery.

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College of Human Sciences and Humanities, University of Houston - Clear Lake, Houston, Texas. Electronic address:
Neuropsychiatric Research Institute, Fargo, North Dakota.
General Surgery Clinic, Washington University Medicine, Seattle, Washington.
Weill Cornell Medicine, New York, New York.
Department of Surgery Brody School of Medicine at East Carolina University, Greenville, North Carolina.
Department of Plastic Surgery, University of Pittsburgh, Pittsburgh, Pennsylvania.
Oregon Health and Science University, School of Medicine, Portland, Oregon.



Bariatric surgery usually results in substantial weight loss and a reduction in medical comorbidities. Many patients, as a consequence of the weight loss, subsequently evidence loose, redundant skin.


This investigation seeks to examine the prevalence of body contouring surgery (BCS) by patients approximately 4 to 5 years after Roux-en-Y gastric bypass surgery. Demographics, change in BMI, and psychosocial variables were also used to predict body dissatisfaction, desire for BCS, and patients who reported obtaining BCS.


The clinical sites involved in the Longitudinal Assessment of Bariatric Surgery project, which included 10 hospitals across the United States.


The sample comprised 1159 patients who underwent Roux-en-Y gastric bypass and were enrolled in the Longitudinal Assessment of Bariatric Surgery-2 study. Participants were surveyed using the Excessive Skin Survey and other psychosocial measures at their 4- or 5-year postoperative outcome. The participants were predominately women (80.5%), Caucasian (88.3%), and middle-aged (mean = 46.1 yr, standard deviation = 11.11 yr).


Participants reported modest degrees of being bothered by excessive skin, primarily in their waist/abdomen, thighs, and chest/breasts body areas. Only 11.2% of the sample had undergone any BCS procedure, and a majority of those participants paid "out of pocket" for BCS. Desire for BCS and body dissatisfaction 4 to 5 years postsurgery was associated with higher depression scores and poorer quality of life scores.


Excessive skin is associated with poorer psychosocial functioning. Despite reporting modest levels of being bothered by excessive skin and body dissatisfaction, only a small fraction of participants underwent BCS. Cost of BCS was reported to be a primary barrier for not obtaining BCS. All rights reserved.


Bariatric surgery; Body contouring surgery; Excess skin; Plastic surgery; Psychosocial

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