Abdominoplasty following gastrointestinal bypass surgery.

An increasing number of postgastrointestinal bypass patients are being referred for secondary plastic surgical procedures. Thirteen patients at this institution have undergone abdominoplasty after surgery for morbid obesity in the past 5 years. The characteristic abdominal deformity includes a draping apron of panniculus frequently associated with previous surgical scars and/or ventral hernia. An abdominoplasty of the low, transverse type with wide undermining is appropriate for most patients. However, vertical or mixed-type abdominoplasties and simple panniculectomies are occasionally indicated owing to residual adiposity and scar location. After bypass surgery, self-image and health-related complaints are markedly improved, but psychological gains can be inhibited by persistent body-contour concerns. Gastrointestinal bypass patients have a high incidence of associated medical problems. Preoperative laboratory evaluations must, therefore, be comprehensive. A variety of early and late complications following gastric and jejunoileal bypass are summarized. In spite of an expected higher complication rate following abdominoplasty, no major complications and three minor complications were discovered in these 13 patients.