Changing Body Image and Well-Being: Following the Experience of Massive Weight Loss and Body Contouring Surgery

Ethical Considerations and Outcomes in Body Contouring Surgeries Among Adolescents: A Comprehensive Narrative Review

BACKGROUND

Body contouring surgery (BCS) in adolescents, particularly following bariatric surgery, involves a complex array of ethical, psychological, and medical factors. This review focuses on adolescents who have experienced significant weight loss, often due to bariatric surgery, and subsequently require body contouring to address excess skin and soft tissue.

METHODS

A literature narrative review was conducted using PubMed and Google Scholar databases. Relevant articles were screened and selected based on their discussion of post-bariatric and massive weight loss body contouring surgeries in adolescents, focusing on prevalence, outcomes, and ethical considerations.

RESULTS

The prevalence of BCS among adolescents is rising, influenced by social media and societal perceptions of beauty. However, the percentage of adolescents receiving BCS after bariatric surgery remains low. Adolescents undergoing BCS experience improvements in physical functioning, body image, and psychological well-being. Complications, although common, are mostly minor. Ethical considerations include ensuring informed consent, assessing emotional maturity, managing patient expectations, and involving adolescents in decision-making. Comparative analysis reveals similar outcomes in adults and adolescents, but adolescents face unique ethical challenges related to autonomy, long-term effects, and ongoing physical and emotional development.

CONCLUSION

BCS in adolescents following bariatric surgery can lead to improved physical and psychological outcomes. However, the decision to undergo BCS must be carefully considered, taking into account the adolescent's maturity, expectations, and long-term well-being. Ethical considerations are paramount, emphasizing the need for informed consent, realistic expectations, and a multidisciplinary approach. Further research is needed to assess long-term outcomes and the specific ethical implications of BCS in adolescents compared to adults.

LEVEL OF EVIDENCE V

This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Novel insights into patient's thoughts about their body image in abdominal wall hernia

BACKGROUND

Abdominal wall hernias (AWH) are frequently large and deforming. Despite this, little is known about how AWH impact upon body image. This study is the first study to qualitatively examine patients' subjective lived experiences of how AWH affects their body image.

METHODS

Fifteen patients were interviewed from a purposive sample of AWH patients awaiting surgery until no new narrative themes emerged. Interviews explored patient thoughts and experiences of AWH and body image. Data were examined using interpretative phenomenological analysis (IPA).

RESULTS

Two key themes pertaining to body image were identified: "Changes to perceptions of self" and "Fears concerning other's perceptions of them". Both themes were often interrelated and displayed detrimental effects AWH had on patients' body image.

CONCLUSIONS

Our findings illustrate that AWH detrimentally affected patients' body image. This aspect of patient care can be treated and managed through better pre-operative information, including on body image as part of a holistic needs assessment (HNA), and ensuring the results are addressed in a patient care package. These development suggestions may positively affect the AWH patient's experience and outcomes in terms of Quality of Life (QoL) by preparing patients better for realistic results regarding what can be achieved in terms of form, function thus making a more holistic recovery from surgery.

Determinants of the influence and experiences of cosmetic and aesthetics profiling on interpersonal relationships among Indian patients

BACKGROUND

The notion of facial beauty is a fast-expanding field in many different disciplines. The determinants and the nature of inter-personal relationships remain a controversial issue. Here, we tackle such questions proposing a novel experimental approach by analyzing first-hand experiences and quality of life among Indian patients, who underwent cosmetic procedures and the subsequent impact of these aesthetic treatments on interpersonal relationships.

METHODS

The data collection tool consisted of questions pertaining to the relations between the human face and facial image, relations between the race and facial image and interpersonal relationships and facial image. The tool consisted of 27 questions that were descriptive and closed ended without alternate choices.

RESULTS

The study gauged the perception of an ideal facial image among both genders also highlighting the multifaceted nature of a persons' beauty and how its perception is affected by peers, society, and race.

CONCLUSION

Though there was a gender-based difference found in the opinions on facial image, majority of the people experienced an ameliorated experience in their relationships with family and peers.

Post-Bariatric Plastic Surgery: Abdominoplasty, the State of the Art in Body Contouring

Due to the increased prevalence of obesity in the last decades, bariatric surgery has been on the rise in recent years. Bariatric surgery is a compelling option for weight loss in obese patients with severe obesity-related comorbidities or for whom lifestyle modifications have proven ineffective. Redundant skin following significant weight loss is a common occurrence affecting up to 96% of patients who undergo bariatric surgery, negatively impacting physical and psychosocial health and detracting from activities of daily living. Statistics of the American Society of Plastic Surgeons show that 46,577 body contouring procedures were performed after massive weight loss in the USA in a 2020 report. Abdominoplasty, a well-established cosmetic surgery procedure for improving body contour, is performed by removing excess skin and fat from the abdominal wall and thereby restoring musculofascial integrity and skin elasticity, resulting in a more ideal body shape and increasing quality of life. Although abdominoplasty is a safe procedure, it has been associated with a higher complication rate compared with other body-contouring procedures. Technologic advances over the past decade have been developed as non-invasive alternatives or adjunctive tools to surgery to enhance cosmetic results and minimize complications. New energy-based technologies may supplant invasive surgery for mild to moderate skin laxity and/or diminish the extent of surgery and resulting scars. Plastic surgeons play a significant role in improving the quality of life of patients who suffer from obesity and underwent bariatric surgery. We are deeply convinced, however, that the advancement of knowledge and research in this field will determine the introduction of new technologies and custom-made techniques. This advancement will reduce the complication rate with a rapid reintegration of the patient into the world of work and resumption of daily activities.

Evolution of the body image perception of people with obesity on the pathway from bariatric surgery to body contouring lift surgery

INTRODUCTION

Being obese has a significant impact on the quality of life limiting physical condition, life and professional activity, causing lack of acceptance from the environment, and a disturbing self-esteem. The main aim of this study is to identify which factors contribute to changes of self-esteem and satisfaction of female patients' body image perception as well as their correlation during the various stages of bariatric therapy.

METHODS

This prospective observational study included 438 bariatric female patients and a control group that consisted of 127 female subjects with reference body weight and BMI. Parametric data were collected in all the subgroups; anthropometric measurements and subjective assessment of body image were checked depending on the stage of bariatric treatment.

RESULTS

The body image and self-esteem of bariatric patients is changing according to the stage of bariatric treatment. At the beginning of the bariatric pathway, patients are characterized by a negative body image and low self-esteem. Women undergoing contour lifting surgery got the highest score, even higher than women from the control group. The lowest scores are in the group entering the therapy and 24 h after surgery. A more favorable body image and a higher self-esteem were presented by patients with higher education and a better financial situation.

CONCLUSION

For female bariatric patients, the body image and self-esteem scores are higher with the consecutive stages of treatment. A more favorable body image and higher self-esteem is demonstrated with patients having a higher education and a better financial situation.

A Correlative Study Between Personality Traits and the Preference of Site Selection in Cosmetic Treatment

Background: Cosmetic treatment was closely associated with beauty seekers' psychological well-being. Patients who seek cosmetic surgery often show anxiety. Nevertheless, not much is known regarding how personality traits relate to the selection of body parts that receive cosmetic treatment. Aims: This study aims to investigate the correlation between personality traits and various selection sites for cosmetic treatment via Eysenck Personality Questionnaire (EPQ). Methods: A cross-sectional approach was adopted to randomly recruited patients from a general hospital planning to undergo cosmetic treatments. All respondents completed the EPQ and provided their demographic information. The EPQ involves four scales: the extraversion (E), neuroticism (N), psychoticism (P), and lying scales (L). Psychological scales were evaluated to verify that people who selected different body sites for cosmetic intervention possessed different personality portraits. Results: A total of 426 patients with an average age of 32.14 ± 8.06 were enrolled. Among them, 384 were females, accounting for more than 90% of patients. Five treatment sites were analyzed, including the body, eye, face contour, nose, and skin. Comparatively, patients with neuroticism were more likely to undergo and demand rhinoplasty (OR 1.15, 95% CI 1.07-1.24, P < 0.001). Face contour treatment was commonly associated with extraversion (OR 1.05, 95% CI 1.00-1.11, P = 0.044), psychoticism (OR 1.13, CI 1.03-1.25, P = 0.013), and neuroticism (OR 1.05, CI 1.01-1.10, P = 0.019). Conclusions: This novel study attempted to determine the personality profiles of beauty seekers. The corresponding assessments may provide references for clinical treatment options and enhance postoperative satisfaction for both practitioners and patients.

The Impact of Massive Weight Loss on Psychological Comorbidities: A Large, Retrospective Database Review

BACKGROUND

The obese population has a higher incidence of mood disorders compared to individuals with normal body mass index (BMI). A better understanding of the unique psychosocial challenges faced by this patient population will allow physicians to better optimize patient psychosocial support systems perioperatively, as well as help the patient to maintain appropriate expectations.

METHODS

A large, retrospective database of 1135 patients with greater than 50 pounds of weight loss was reviewed. Data were analyzed using a multinomial regression model to determine the influence of psychosocial factors on the incidence of depression and anxiety.

RESULTS

Prior to massive weight loss, patients reported an overall incidence of depression and anxiety of 42.5% and 26.3%, respectively. Following massive weight loss, the incidence of depression decreased to 32.3% and the incidence of anxiety decreased to 22.0%. Patients with spousal support and with positive self-image were more likely to experience resolution of depression. Patients with positive self-image were likely to experience resolution of anxiety. Resolution of medical comorbidities correlated with a decrease in the rate of depression.

CONCLUSION

Depression and anxiety are prevalent in the massive weight loss patient population undergoing body contouring surgery. Support systems are a vital resource for patients with psychological comorbidities undergoing massive weight loss. Patients who have a positive self-image of themselves are more likely to experience resolution of psychological comorbidities. Physicians should consider recommending support groups and/or counseling in patients who have poor support and negative self-image.

LEVEL OF EVIDENCE IV

This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.