Body Contour in the Post-Bariatric Male Patient

Background: Obesity is currently considered a public health problem. Bariatric procedures have become an important part of obesity management and, consequently, the number of male patients seeking post-bariatric reconstructive procedures have increased. Therefore, the clinical approach and understanding of the body contour of this population have become more relevant. The goal of post-bariatric reconstruction is to enhance the male silhouette through removal of skin and adipose tissue excess, and abdominal rectus diastasis repair. Material and Methods: We conducted a retrospective study at the Plastic and Reconstructive Surgery Department of the National Medical Center “20 de Noviembre”. All male patients referred to our department to start a post-bariatric reconstruction protocol from January 2018 to December 2022 were included in this study. Results: In total, 15 patients who underwent corporal contouring procedures were included;median age was 49.2 years with minimum of 33 years, and a maximum of 57 years. Median Body mass index was 28.4 kg/m2 with minimum of 22 kg/m2 and maximum of 38 kg/m2. All patients were treated 18 months after their bariatric surgery. All patients underwent an abdominoplasty as a body contouring procedure. 4 (26.7%) patients presented complications related to the surgery. Conclusion: We described a comprehensive and systematic approach to massive weight loss for male patients, suggesting an abdominal marking based on the patient’s clinical features and the expected results avoiding feminization of the abdominal body contour.

Retrospective: Mammoplasty with Prosthesis after Video-Assisted Bariatric Surgery with Transverse Bipediculated Flap

Objective: To assess the rate of mammary prosthesis extrusion after mammoplasty with prosthesis implantation, to verify the resulting shape and the degree of patient satisfaction after the use of a transverse bipediculated flap with lateral irrigations. Methods: 30 patients with a weight loss of 50 kg on average after video-assisted bariatric surgery, with ptosis and excessive volumes, who underwent mammoplasty with prosthesis placement with volumes ranging from 190 to 260 cc, using a transverse flap with the aim of anchoring the silicone prosthesis. Results: In the patients’ evaluation, the few postoperative complaints did not amount to complications. Pains were minimal and the discomfort with the prosthesis was acceptable. Conclusion: the transverse flap, in addition to acting as the best anchor among the existing flaps for implanted prostheses, provided a youthful, natural, anatomical, aesthetic and longer lasting appearance for the breasts.

The experience performing extended abdominoplasty in massive weight loss patients

Aim: The post-bariatric patients who undergo torsoplasty often incur postoperative complications that dilate their recovery time. The authors propose the technique of extended abdominoplasty, described in 2012 for aesthetic torso remodeling, in post-bariatric patients in order to reduce complications and hospitalization time. Methods: The authors performed 21 extended abdominoplasties and compared them with 21 torsoplasties in post-bariatric patients during a 1-year period. Data studied was age, gender, duration of the procedure, blood loss, complications and hospitalization duration. Results: Peri and postoperative bleeding led to 3 cases of anemia necessitating blood transfusions in 14.3% of the second group;no blood transfusion was needed in the first group. No other major complications occurred during the postoperative period in both groups. Conclusion: The authors believe that extended abdominoplasty is a viable alternative to the torsoplasty in selected patients presenting a severe adipocutaneous circumferential laxity, as occurs in post-bariatric patients with a significant weight loss.