The Finishing Touch: body contouring after bariatric surgery

With pronounced weight loss, redundant abdominal skin and lax abdominal muscles cause the patients to feel unattractive. Correction of the cosmetic problem is an important step in promoting increased self-esteem, as well as providing relief from the various unpleasant symptoms caused by a large pannus. Body contouring is a procedure bariatric surgeons should provide for their patients. Panniculectomy is the most commonly performed operation. It provides many benefits, not the least of which is markedly improved appearance. Unfortunately, many surgeons fail to tighten the abdominal muscles while performing the panniculectomy. Although the redundant skin is removed, a ‘pot belly’ deformity of the lower abdomen persists. A technique has been developed for tightening the abdominal musculature, resecting the pannus, and on some patients, performing limited liposuction. A nicely flattened abdomen with a narrowed waistline is the result. Ninety-seven patients have undergone this operation in our hands over the past 3 years. The technique is described, and postoperative management discussed.