Physical measurements and patients’ perception of excess skin on arms and thighs before and after bariatric surgery

Abstract

Background Bariatric surgery is an effective weight loss method for patients with obesity. One side effect of bariatric surgery is uncomfortable excess skin. Much remains to be learned about physical measurements and patients’ subjective perceptions of it. Here, we investigated the pre- to post-bariatric changes in patients’ perception and physical measurements of the skin on the arms and thighs, in order to find possible subgroups especially affected by post-operative excess skin and to identify predicting factors. Methods One hundred forty-seven patients eligible for bariatric surgery completed the Sahlgrenska Excess Skin Questionnaire (SESQ) and underwent measurements of their skin before and 18 months after the procedure. Results Although most physical measurements decreased post-operatively, many patients reported increased discomfort. We identified one subgroup particularly prone to report excess skin on the arms post-operatively: women with high discomfort from excess skin on the arms and high body mass index (BMI), pre-operatively. Ptosis of the excess skin seems to be a feasible measurement for predicting post-operative discomfort. For every centimetre of ptosis pre-operatively, patients had 1.37- and 1.31-fold higher odds of achieving a score for post-operative discomfort from excess skin on the upper arms and thighs, respectively, of ≥ 6 (on a 0–10 scale). Conclusions We identified a subgroup especially affected by discomforting excess skin on arms and thighs after weight loss. Furthermore, we suggest a pre-operative pro-operative ptosis measuring to predict post-operative discomfort level. The result of this study further increases the knowledge of excess skin and should be useful in further improving patient education. Level of Evidence: Level III, risk / prognostic study.

Factors Associated with Excess Skin After Bariatric Surgery: a Mixed-Method Study

“…A better understanding of factors associated with ES quantity post-MBS is essential to help identify patient pre-MBS at risk of greater ES, and prepare them to realistic expectations [8]. In line with prior studies [4,8,29], quantitative and qualitative results suggest maximal BMI, pre-MBS and current BMI, but not psychosocial factors, are related to ES quantity post-MBS. As these findings were retrospective, these results need to be confirmed in prospective longitudinal studies.…”

“…As a result, methods relying on measured ES (M-ES) quantity are employed. Unfortunately, because few studies have investigated these outcomes together, evidence is lacking to ascertain if Sr-ES and M-ES quantity are associated (and provide evidence of convergent validity), and whether they relate to inconveniences caused by ES [4,8].…”

Desire for Body Contouring Surgery after Bariatric Surgery: A Nationwide Cross-sectional Study in Saudi Arabia

“…Additionally, according to findings of a study that evaluated the changes following BS in perception and physical measurements of arm and thigh skin and degree of excess skin discomfort, female participants had experienced significantly more excess skin and higher discomfort in the arms than male participants. 26 Furthermore, Biörserud et al 27 and Staalesen et al 23,25 reported a similar finding concerning excess skin and discomfort on several body parts. In this study, the time elapsed since BS correlated negatively and significantly with the desire for BCS; this is in line with prior studies.…”