Long-Term Quality-of-Life Outcomes After Body Contouring Surgery: Phase IV Results for the Body-QoL® Cohort

BACKGROUND

Body contouring surgery (BCS) is becoming increasing popular for aesthetic and reconstructive purposes, particularly among patients with massive weight loss (MWL). However, data on quality of life (QoL) following the surgery are limited, especially long-term QoL.

OBJECTIVES

The authors evaluated the effect of BCS on QoL and the durability of this effect over time.

METHODS

QoL was measured with the Body-QoL® instrument at 3 time points among consecutively treated patients: the day before BCS, 1 to 9 months postoperatively (short term), and 1 to 2.7 years postoperatively (long term). Total Body-QoL scores were compiled, as were scores for the instrument's main domains: body satisfaction, sex life, self-esteem and social performance, and physical symptoms. Scores were examined for the entire study population and separately for the cosmetic and MWL cohorts.

RESULTS

Fifty-seven of the 112 patients participated in the short-term assessment and 84 in the long-term assessment. Total Body-QoL scores increased significantly (P < 0.0001), from 44.0 ± 14.1 preoperatively to 85.5 ± 17.5 short-term postoperatively and to 84.4 ± 12.7 long-term postoperatively. Scores for the 2 postoperative assessments did not differ significantly. Similar results were observed for scores on each separate domain. Although preoperative scores were lower for the MWL cohort than the cosmetic cohort (33.9 ± 15.6 vs 46.1 ± 12.8; P = 0.0002), they improved substantially after BCS, approaching scores for the cosmetic cohort.

CONCLUSIONS

QoL increases significantly after BCS. This favorable outcome remained stable throughout long-term follow-up and was true for the cosmetic and MWL cohorts.

LEVEL OF EVIDENCE 4

Distribution of microplastics present in a stream that receives discharge from wastewater treatment plants

The presence of microplastics (MPs) in freshwater systems that receive discharge of urban effluent implies a great environmental impact. In order to be able to generate proposals that solve this problem, it is necessary to know in detail the contributions of different MPs sources. The aim of this work was to study the contribution of urban sewage discharge to MPs pollution in a stream that runs through a medium-sized city. The spatial distribution of MPs with sizes between 100 μm and 1.5 mm present in surface water was measured and their characteristics, dimensions, shapes and identification were determined. Physical-chemical parameters of the stream water were measured, and a decrease in water quality was found due to wastewater treatment plants. The main source of MPs was effluent from the plants (97% of the total MPs), while the rest came from storm drains and discharge of tributaries. The maximum concentration of MPs found was around 72,000 MP/L (equivalent to 53 million MPs/s), at a point after discharge from both plants. Around 70% of MPs correspond to microfibers with a mean length of around 300 μm and a mean width of around 15 μm, and they are mainly polyethylene fibers. The remaining 30% of MPs are particles with lengths of around 140 μm. The transport of MPs between a point located after discharge of the plants and another point located about 3 km further on was studied, and no significant variation was found in the concentration of MPs. Electrical conductivity was used as a conservative tracer of MPs concentration. This work presents for the first time a detailed analysis of different contributions of MPs to a freshwater system in South America, which receives discharge of wastewater treatment plants, evidencing its important role in pollution.

Study of a stream in Argentina with a high concentration of microplastics: Preliminary analysis of the methodology

This study presents for the first time results about the microplastic concentration and their origin in a stream of the Pampas region in Argentina, receiving wastewater of an intermediate city. The most appropriate procedure to analyze and quantify the microplastics in the studied system is the use of an oxidative digestion process using a 30% H₂O₂ solution to eliminate the organic matter in the samples. A high quantity of MPs, on the order of millions of microplastics per m³ of water, was estimated in the Langueyú stream. 56% of the microplastics correspond to fibers with diameters between 10 and 15 μm and lengths less than 500 μm, while 44% are fragments with sizes of tens of micrometers. Raman microspectroscopy was used to identify the type of fibers. The characteristics of the microplastic fibers released in a wash load test are comparable with those observed in the Langueyú stream, in particular, the average sizes and the distribution of the diameters of the MPFs are similar. The processes in the sewage treatment plant, prior to their discharge in the stream, would affect the color of the fibers and their length.

Temporal variation of the microplastic concentration in a stream that receives discharge from wastewater treatment plants

The temporal variation of the microplastic concentration was studied in the Langueyú stream, which is located in the department of Tandil, in the southeast of the Buenos Aires province in Argentina. This stream receives discharge from the wastewater treatment plants from a medium-sized city. A quantitative analysis of the microplastic concentration was carried out in different samplings, corresponding to different seasons. The study focused on the most contaminated point, located after the discharge of effluents from plants. Higher concentrations of MPs were found in winter (dry season), having approximately 6 times the concentrations found in summer and autumn (wet seasons). However, these differences would not be a direct consequence of the amount precipitation, but rather would be associated with a seasonal variation of human activities, mainly with respect to the type of clothing used in the cold season. The microfibers correspond to around 60-90% of microplastics found. The discharge from the plants causes changes in the parameters of the stream water, such as high electrical conductivity values, and also provide metallic contaminants such as Ca, Zn, and in smaller amounts Pb, Fe, Ni and Cu, which were found adhered to the microplastics and remain in the stream water in high quantities 3 km after the study point. The microplastic concentration presents a linear empirical correlation with the conductivity, and it was found that conductivity measurements would serve as an indicator of the microplastic concentration in the system under study.