Body contouring surgery decreases long-term weight regain following laparoscopic adjustable gastric banding: A matched retrospective cohort study

Background: Laparoscopic adjustable gastric banding (LAGB) surgery is the safest yet least effective method for massive weight loss. Thirty to 50 percent of patients undergoing LAGB will regain part of their lost weight. Objective: To evaluate the effect of body contouring plastic surgery (BCPS) following LAGB on long-term body mass index (BMI) control. Setting: Department of Surgery A, Soroka University Medical Center, Beer-Sheva, Israel. Methods: A retrospective cohort study of patients aged 18-50 years, who underwent LAGB surgery between 1997 and 2007, was performed. Out of 2405 patients undergoing LAGB during those years, 861 were excluded and 1544 were recruited by phone. The final group included 72 patients matched for age and gender. Long-term weight regain was evaluated and compared between a group of patients who underwent subsequent body contouring plastic surgery (LBCPS) and a group of LAGB only (LAGBO). Groups were matched for age, gender, and pre-operative body mass index (BMI). Results: LBCPS (n = 18) had lower endpoint BMI and BMI regain percentage compared with LAGBO (n = 54) (24.64 perpendicular to 3.76 vs. 31.0 perpendicular to 7.2 kg/m(2), p < 0.001; 13 perpendicular to 14% vs. 34 perpendicular to 31%. p < 0.001, respectively). BCPS had an independent strong protective effect for endpoint BMI regain over 25% and BMI >= 30 kg/m(2) (HR = 0.19, p = 0.025; HR = 0.13, p = 0.046, respectively). Conclusion: When compared with patients who did not undergo BCPS following LAGB, patients who underwent BCPS following LAGB had improved long-term BMI control. (C) 2016 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.