Understanding excess skin in postbariatric patients: objective measurements and subjective experiences

Background: Excess skin is a well-known side effect of massive weight loss after bariatric surgery. However, there is a lack of longitudinal follow-ups. Objectives: The primary aims of this study were to investigate the development and amount of excess skin after laparoscopic Roux-en-Y gastric bypass and to relate objective results to subjective experiences. Setting: University hospital. Methods: From 2009 to 2012, 200 patients were included and assessed with respect to excess skin before and 18 months after bariatric surgery. Patients were measured according to a standardized protocol and completed a questionnaire regarding their subjective experience of excess skin. Results: A follow-up visit was completed in 149 patients (78%). All ptosis measurements decreased after weight reduction except for ptosis on the thighs. When comparing objective measurements with patients' subjective experience and discomfort from excess skin, we found little or low correlation in most body parts (r(s).03-.67). The prediction analysis indicated that, for every centimeter of ptosis on the abdomen preoperatively, there was a 2-fold greater probability of having a postoperative ptosis on the abdomen of >3 cm (OR = 2.32, 1.76-3.07). Conclusion: The objective measurement of excess skin provides unique information in postbariatric patients' body habitus. Although the measured excess skin decreased compared with preoperative measurements, patients seem to become more aware of and disturbed and discomforted by it after the weight loss. Importantly, the objectively assessed measurements of excess skin correlated fairly with the perceived discomfort. (C) 2016 American Society for Metabolic and Bariatric Surgery. All rights reserved.