Andrea Lazzati1, Sandrine Katsahian2, David Maladry3, Emma Gerard4, Sonia Gaucher3. 1. Department of General Surgery, Center Hospitalier Intercommunal de Créteil, Créteil, France; INSERM, UMR_S 1138, Université Paris Descartes, Centre de Recherche des Cordeliers, Paris, France. Electronic address: andrea.lazzati@chicreteil.fr. 2. INSERM, UMR_S 1138, Université Paris Descartes, Centre de Recherche des Cordeliers, Paris, France; Assistance Publique - Hôpitaux de Paris, Hôpital Européen Georges-Pompidou, Unité d'Épidémiologie et de Recherche Clinique, Paris, France; INSERM, Centre d'Investigation Clinique 1418, module Épidémiologie Clinique, Paris, France; Faculté de Médecine, Université Paris Descartes, Paris, France. 3. Faculté de Médecine, Université Paris Descartes, Paris, France; Assistance Publique - Hôpitaux de Paris, Hôpital Cochin, Service de Chirurgie Générale, Plastique et Ambulatoire, Paris, France. 4. INSERM, UMR_S 1138, Université Paris Descartes, Centre de Recherche des Cordeliers, Paris, France.
Abstract
BACKGROUND: Bariatric patients are often candidates for plastic surgery. However, the rate of postbariatric procedures is not known. OBJECTIVES: The aim of this study was to analyze the rate of plastic surgery, and factors related to surgery, in bariatric patients. SETTING: University hospital, France. METHODS: This was a cohort study based on administrative data. All adult patients who received bariatric surgery in France between 2007 and 2013 were included to estimate the rate of plastic surgery and related predictive factors. Data are reported according to the reporting of studies conducted using observational routinely collected data guidelines for observational studies on administrative data. RESULTS: Among the 183,514 patients who underwent bariatric surgery in the study period, 23,120 plastic surgeries were performed on 17,695 patients, including abdominoplasty (62%), dermolipectomy of the upper or lower limbs (25%), and reconstruction of the breast (14%). The rates of plastic surgery were 13%, 18%, and 21% at 3, 5, and 7 years post-bariatric surgery, respectively. Multivariate analysis revealed that patients who had a biliopancreatic diversion or a gastric bypass had a hazard ratio of 2.67 and 2.67 for subsequent plastic surgery, respectively, compared with patients who had adjustable gastric banding. Women had a 2-fold probability of surgery compared with men (hazard ratio 2.02). Important variability in the rate of surgery was found among different hospitals; rates ranged from 6.1% to 41.3% at 5 years. CONCLUSIONS: This study showed that 21% of bariatric patients undergo plastic surgery. Large variability exists among hospitals, suggesting that several unmeasured factors may limit access to contouring surgery.
BACKGROUND: Bariatric patients are often candidates for plastic surgery. However, the rate of postbariatric procedures is not known. OBJECTIVES: The aim of this study was to analyze the rate of plastic surgery, and factors related to surgery, in bariatric patients. SETTING: University hospital, France. METHODS: This was a cohort study based on administrative data. All adult patients who received bariatric surgery in France between 2007 and 2013 were included to estimate the rate of plastic surgery and related predictive factors. Data are reported according to the reporting of studies conducted using observational routinely collected data guidelines for observational studies on administrative data. RESULTS: Among the 183,514 patients who underwent bariatric surgery in the study period, 23,120 plastic surgeries were performed on 17,695 patients, including abdominoplasty (62%), dermolipectomy of the upper or lower limbs (25%), and reconstruction of the breast (14%). The rates of plastic surgery were 13%, 18%, and 21% at 3, 5, and 7 years post-bariatric surgery, respectively. Multivariate analysis revealed that patients who had a biliopancreatic diversion or a gastric bypass had a hazard ratio of 2.67 and 2.67 for subsequent plastic surgery, respectively, compared with patients who had adjustable gastric banding. Women had a 2-fold probability of surgery compared with men (hazard ratio 2.02). Important variability in the rate of surgery was found among different hospitals; rates ranged from 6.1% to 41.3% at 5 years. CONCLUSIONS: This study showed that 21% of bariatric patients undergo plastic surgery. Large variability exists among hospitals, suggesting that several unmeasured factors may limit access to contouring surgery.