Background: Obesity is currently considered a public health problem. Bariatric procedures have become an important part of obesity management and, consequently, the number of male patients seeking post-bariatric reconstructive procedures have increased. Therefore, the clinical approach and understanding of the body contour of this population have become more relevant. The goal of post-bariatric reconstruction is to enhance the male silhouette through removal of skin and adipose tissue excess, and abdominal rectus diastasis repair. MaterialandMethods:We conducted a retrospective study at the Plastic and Reconstructive Surgery Department of the National Medical Center “20 de Noviembre”. All male patients referred to our department to start a post-bariatric reconstruction protocol from January 2018 to December 2022 were included in this study. Results: In total, 15 patients who underwent corporal contouring procedures were included; median age was 49.2 years with minimum of 33 years, and a maximum of 57 years. Median Body mass index was 28.4 kg/m2 with minimum of 22 kg/m2 and maximum of 38 kg/m2. All patients were treated 18 months after their bariatric surgery. All patients underwent an abdominoplasty as a body contouring procedure. 4 (26.7%) patients presented complications related to the surgery. Conclusion: We described a comprehensive and systematic approach to massive weight loss for male patients, suggesting an abdominal marking based on the patient’s clinical features and the expected results avoiding feminization of the abdominal body contour.
References
[1]
The American Society of Plastic Surgeons (2020) Plastic Surgery Statistics Report. ASPS National Clearinghouse of Plastic Surgery Procedural Statistics. USA. https://www.plasticsurgery.org/documents/News/Statistics/2020/cosmetic-procedure-trends-2020.pdf
[2]
Matarasso, A. (2004) The Male Abdominoplasty. Clinics in Plastic Surgery, 31, 555-569. https://doi.org/10.1016/j.cps.2004.03.013
[3]
WHO (2023) Obesity and Overweight. https://www.who.int/news-room/fact-sheets/detail/obesity-and-overweight
[4]
Instituto Nacional de Salud Pública (MX) and Encuesta Nacional de Salud y Nutrición (2018) National Health and Nutrition Survey 2018. Cuernavaca, México. https://ensanut.insp.mx/encuestas/ensanut2018/doctos/informes/ensanut_2018_presentacion_resultados.pdf
[5]
ASMBS (2023) Estimate of Bariatric Surgery Numbers [Internet]. American Society for Metabolic and Bariatric Surgery. https://asmbs.org/resources/estimate-of-bariatric-surgery-numbers
[6]
Telich-Vidal, J., Ramírez-Sosa, L.E., Ángeles-Gaspar, D. and Telich-Tarriba, J.E. (2020) Cirugía postbariátrica: El último eslabón en el protocolo de cirugía metabólica. CirugíaPlástica, 30, 172-179. https://doi.org/10.35366/98343
[7]
Hurwitz, D. (2020) Enhancing Masculine Features after Massive Weight Loss. Aesthetic Plastic Surgery, 44, 1241-1251. https://doi.org/10.1007/s00266-020-01811-1
[8]
Portes-Castro, A., Morales-Olivera, J.M., Corona-García, R., Pratti-Budrovich, V., Albores-De-La-Riva, N., Rodríguez-Romo, D., etal. (2016) Clinical Guidelines for the Interdisciplinary Management of Patients with Sequelae of Massive Weight Loss during Reconstructive Plastic Surgery. CirugíaPlásticaIberolatinoamericana, 42, 77-91.
[9]
Ghnnam, W., Elrahawy, A. and EL Moghazy, M. (2016) The Effect of Body Mass Index on Outcome of Abdominoplasty Operations. World Journal of Plastic Surgery, 5, 244-251.
[10]
Yu, D., Novicoff, W.M. and Gampper, T.J. (2016) The Average Size and Position of the Umbilicus in Young Men and Women. Annals of Plastic Surgery, 76, 346-348. https://doi.org/10.1097/SAP.0000000000000478
[11]
Zarins, U. and Sandis, K. (2015) Anatomy for Sculptors: Understanding the Human Figure. Anatomy Next, Incorporated.
[12]
Donato, D.P., Simpson, A.M., Garlick, J.W., Kwok, A.C., Crombie, C. and Agarwal, J.P. (2019) Abdominal Contouring and Male Gender. Annals of Plastic Surgery, 83, 481-487. https://doi.org/10.1097/SAP.0000000000001785
[13]
Gusenoff, J.A. (2019) Managing Body Contouring Challenges and Complications. Springer. https://doi.org/10.1007/978-3-030-03068-1
[14]
Chong, T., Coon, D., Toy, J., Purnell, C., Michaels, J. and Rubin, J.P. (2012) Body Contouring in the Male Weight Loss Population. Plastic and Reconstructive Surgery, 130, 325e-330e. https://doi.org/10.1097/PRS.0b013e3182589adb
[15]
Ngaage, L.M., Elegbede, A., Pace, L., Rosen, C., Tannouri, S., Rada, E.M., etal. (2020) Review of Insurance Coverage for Abdominal Contouring Procedures in the Postbariatric Population. Plastic and Reconstructive Surgery, 145, 545-554. https://doi.org/10.1097/PRS.0000000000006513
[16]
Ngaage, L.M., Wasicek, P.J., Puthumana, J., Kambouris, A.R., Tannouri, S., Rada, E.M., etal. (2020) A Cross-Sectional Analysis of Insurance Coverage of Extremity Contouring after Massive Weight Loss. Annals of Plastic Surgery, 84, 253-256. https://doi.org/10.1097/SAP.0000000000002150