The procedures used in body contouring are also becoming more refined and predictable, say researchers at the American Society of Plastic Surgeons Plastic Surgery 2006 meeting in San Francisco.
Demand Follows Rise in Bariatric Surgery
Weight loss surgery is known as bariatric surgery. With bariatric surgery procedures, the surgeon helps an obese patient lose weight by operating on the stomach or intestines, often creating a very small stomach pouch.
In 2004, 140,000 bariatric procedures were done in the United States, according to estimates from the American Society for Bariatric Surgery, and 56,000 body contouring procedures followed them, according to the American Society of Plastic Surgeons.
For 2005, these groups estimate about 171,000 bariatric procedures and more than 68,000 body contouring procedures were done.
Traditionally, about 25% to 35% of patents who have bariatric surgery go on to have the body contouring procedures.
"If you eliminate finances from the picture, that number would increase dramatically," says Al Aly, MD, an Iowa City, Iowa, plastic surgeon and expert in the field. Insurance typically covers only part of the procedures or none at all, doctors say. "The number would jump to 70% or 80% [if it was covered by insurance]."
Who Gets Body Contouring?
Younger patients and those who got closer to their ideal weight after the bariatric surgery are more likely to request the body contour procedures, finds Devinder Singh, MD, a researcher and resident in plastic surgery at Yale University in New Haven, Conn.
Singh's team compared 24 patients who underwent body contouring with 169 who did not, trying to find out which factors predict requests for the procedure.
Those who opted for the body contour procedures were, on average, 36 years old; those who declined the extra surgery were, on average, 41. Women greatly outnumbered the men; of the 24 patients, only four were men.
The body contour patients were also closer to their ideal weight than were those who declined it, she found. They had lost 70% of the excess weight they needed to lose, while those who declined had lost just 62% of their excess weight one year after bariatric surgery.
The study results make sense, says Robert Bell, MD, a bariatric surgeon at Yale University and one of Singh's co-researchers. "The more you lose, the more likely you are to need plastic surgery. Younger patients are often more motivated; older patients may accept a little sag."
"Those who lose weight rapidly after bariatric surgery may be more motivated to improve their appearance," says J. Grant Thomson, MD, associate professor of plastic surgery at Yale and another co-author. It's not just about appearance, he tells WebMD. Excess skin can make daily activities and moving around difficult.