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The e-mémoires of the Académie Nationale de Chirurgie

Could Breast Remodeling after Bariatric Surgery be Reasonably Qualified as Aesthetic Surgery?

BRUANT RODIER C | BODIN F | SCHOHN T | DISSAUX C

Seance of wednesday 04 november 2015 (PROBLÈMES ET POLÉMIQUES EN CHIRURGIE PLASTIQUE RECONSTRUCTRICE ET ESTHÉTIQUE DU SEIN)

Abstract

Due to the increase of obesity and bariatric surgery, the demand for plastic surgery after massive weight loss became actually major.Rapid and massive weight loss, far from solving all the problems, leads to postoperative excess skin. Thus patients often became as disturbed by surplus skin as by their previous roundness’s.Body contouring iterative surgeries could be a solution, such as abdominoplasty, body lifting, thigh or arm lift procedures. In France, all these procedures should be subject to pre-approval to be covered by social welfare.Breast is also impaired, empty and floppy, but it represents the only region to be considered as aesthetic surgery on patient’s burden while these men or women ask for repair.This surgery, involving correction of ptosis and breast augmentation on the female patients, is technically demanding. Breast implant is by far the leading technique. Breast augmentation using flaps or lipofilling provides an alternative solution.Secondary corrections and re-interventions are often necessary. Morphological results remain modest and unstable over time, moreover in an initial context of eating and body image disorders, where psychological, financial and social issues, are far from being solved.