Health-Related Quality-of-Life Effects of Rectus Repair during Body Contouring Surgery in Postbariatric Patients: A Prospective Study.

Background: Massive weight loss after bariatric surgery often leads to psychological and physical dissatisfaction, resulting in an increased demand for body contouring surgery (BCS). As a result of these operations, health-related quality of life (HRQL) is improved. However, little is known about the impact of rectus plication during BCS on HRQL.
Methods: This multicenter prospective cohort study included postbariatric primary BCS patients with a minimum follow-up period of 12 months between January of 2016 and December of 2019. Patients were divided into 2 groups based on plication status. Using the BODY-Q, a patient-reported outcome measure, HRQL was measured preoperatively and at least 12 months postoperatively. Six HRQL domains were investigated: body image, physical function, psychological function, sexual function, social function, and physical symptoms.
Results: A total of 305 patients were included in this study: 201 of these patients (66%) did not undergo plication, whereas 104 patients (34%) did. HRQL improved significantly 12 months after BCS in all measured domains, regardless of plication status. Delta scores were significantly higher in the plication group in all HRQL domains. After adjusting for baseline score and other significant variables through multivariate linear regression, 3 scales remained significant: body image ( P = 0.001), psychological function ( P = 0.035), and sexual function ( P = 0.035).
Conclusions: Three of 6 HRQL domains showed significant improvement after BCS with rectus plication, predominantly body image. Preoperative counseling and surgical planning could benefit from this information. The long-term effects of rectus plication on HRQL should be explored in future research.
Clinical Question/level of Evidence: Therapeutic, III.
(Copyright © 2023 by the American Society of Plastic Surgeons.)