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Research ArticleOriginal Article
Open Access

Factors and barriers influencing the decision to undergo body contouring surgery after bariatric surgery

A cross-sectional study

Omar F. Neel, Hatan Mortada, Ghaida AlBraithen, Faisal F. Almutairi, Reem A. Al-Terkawi and Abdelrahman Salem
Saudi Medical Journal November 2023, 44 (11) 1145-1152; DOI: https://doi.org/10.15537/smj.2023.44.11.20230418
Omar F. Neel
From the Department of Surgery (Neel); from the College of Medicine (AlBraithen), King Saud University, from the Department of Surgery (Mortada); from the Department of Plastic Surgery & Burn Unit (Mortada), King Saud Medical City, from Department of Plastic Surgery (Al-Terkawi); from the Department of Bariatric Surgery (Salem), Specialized Medical Center Hospital, Riyadh, from the College of Medicine and Medical Sciences (Almutairi), Qassim University, Qassim, Kingdom of Saudi Arabia, and from the Department of Surgery (Neel), McGill University, Montreal, Canada.
MBBS, FRCSC
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Hatan Mortada
From the Department of Surgery (Neel); from the College of Medicine (AlBraithen), King Saud University, from the Department of Surgery (Mortada); from the Department of Plastic Surgery & Burn Unit (Mortada), King Saud Medical City, from Department of Plastic Surgery (Al-Terkawi); from the Department of Bariatric Surgery (Salem), Specialized Medical Center Hospital, Riyadh, from the College of Medicine and Medical Sciences (Almutairi), Qassim University, Qassim, Kingdom of Saudi Arabia, and from the Department of Surgery (Neel), McGill University, Montreal, Canada.
MBBS
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  • ORCID record for Hatan Mortada
  • For correspondence: [email protected]
Ghaida AlBraithen
From the Department of Surgery (Neel); from the College of Medicine (AlBraithen), King Saud University, from the Department of Surgery (Mortada); from the Department of Plastic Surgery & Burn Unit (Mortada), King Saud Medical City, from Department of Plastic Surgery (Al-Terkawi); from the Department of Bariatric Surgery (Salem), Specialized Medical Center Hospital, Riyadh, from the College of Medicine and Medical Sciences (Almutairi), Qassim University, Qassim, Kingdom of Saudi Arabia, and from the Department of Surgery (Neel), McGill University, Montreal, Canada.
Roles: Medical Intern
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Faisal F. Almutairi
From the Department of Surgery (Neel); from the College of Medicine (AlBraithen), King Saud University, from the Department of Surgery (Mortada); from the Department of Plastic Surgery & Burn Unit (Mortada), King Saud Medical City, from Department of Plastic Surgery (Al-Terkawi); from the Department of Bariatric Surgery (Salem), Specialized Medical Center Hospital, Riyadh, from the College of Medicine and Medical Sciences (Almutairi), Qassim University, Qassim, Kingdom of Saudi Arabia, and from the Department of Surgery (Neel), McGill University, Montreal, Canada.
Roles: Medical Intern
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Reem A. Al-Terkawi
From the Department of Surgery (Neel); from the College of Medicine (AlBraithen), King Saud University, from the Department of Surgery (Mortada); from the Department of Plastic Surgery & Burn Unit (Mortada), King Saud Medical City, from Department of Plastic Surgery (Al-Terkawi); from the Department of Bariatric Surgery (Salem), Specialized Medical Center Hospital, Riyadh, from the College of Medicine and Medical Sciences (Almutairi), Qassim University, Qassim, Kingdom of Saudi Arabia, and from the Department of Surgery (Neel), McGill University, Montreal, Canada.
BSIT
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Abdelrahman Salem
From the Department of Surgery (Neel); from the College of Medicine (AlBraithen), King Saud University, from the Department of Surgery (Mortada); from the Department of Plastic Surgery & Burn Unit (Mortada), King Saud Medical City, from Department of Plastic Surgery (Al-Terkawi); from the Department of Bariatric Surgery (Salem), Specialized Medical Center Hospital, Riyadh, from the College of Medicine and Medical Sciences (Almutairi), Qassim University, Qassim, Kingdom of Saudi Arabia, and from the Department of Surgery (Neel), McGill University, Montreal, Canada.
MD, FRCSC
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  • Article
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Article Figures & Data

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  • Figure 1
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    Figure 1

    - The proportions of reasons for not considering plastic surgeries among those who did not consider body contouring surgery (n=154).

Tables

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    Table 1

    - Sociodemographic characteristics.

    ParametersOverall (N=445)Underwent a body contouring surgeryP-values
    No (n=383)Yes (n=62)
    Age (years)
    18 to <3068 (15.3)57 (14.9)11 (17.7)0.788
    30 to <45241 (54.2)210 (54.8)31 (50.0)
    45 to <60125 (28.1)107 (27.9)18 (29.0)
    60 or more11 (2.5)9 (2.3)2 (3.2)
    Gender
    Male156 (35.1)145 (37.9)11 (17.7)0.002
    Female289 (64.9)238 (62.1)51 (82.3)
    Nationality
    Saudi376 (84.5)320 (83.6)56 (90.3)0.172
    Non-Saudi69 (15.5)63 (16.4)6 (9.7) 
    Relationship status
    Single106 (23.8)88 (23.0)18 (29.0)0.700
    Married303 (68.1)263 (68.7)40 (64.5)
    Divorced31 (7.0)27 (7.0)4 (6.5)
    Widowed5 (1.1)5 (1.3)0 (0.0)
    Level of educational
    Below high school18 (4.0)16 (4.2)2 (3.2)0.926
    High school89 (20.0)78 (20.4)11 (17.7)
    Bachelor degree291 (65.4)248 (64.8)43 (69.4)
    Master degree42 (9.4)37 (9.7)5 (8.1)
    Doctorate degree5 (1.1)4 (1.0)1 (1.6)
    Employment status
    Student21 (4.7)20 (5.2)1 (1.6)0.381
    Unemployed123 (27.6)109 (28.5)14 (22.6)
    Employee247 (55.5)210 (54.8)37 (59.7)
    Other54 (12.1)44 (11.5)10 (16.1)
    Household income per month
    <5,000 SR141 (31.7)125 (32.6)16 (25.8)0.613
    5000-10k SR143 (32.1)120 (31.3)23 (37.1)
    >10k-20k SR102 (22.9)86 (22.5)16 (25.8)
    >20k SR59 (13.3)52 (13.6)7 (11.3)
    Have any comorbidities?
    Yes75 (16.9)64 (16.7)11 (17.7)0.840

    Values are presented as numbers and precentages (%). SR: Saudi Riyals

      • View popup
      Table 2

      - Characteristics of body-contouring surgeries and participants’ attitudes towards these surgeries.

      Parametersn (%)
      Type of the body-contouring surgery*
      Trunk aesthetic surgery42 (67.7)
      Breast aesthetic surgery22 (35.5)
      Extremity aesthetic surgery20 (32.3)
      Liposuction0 (0.0)
      Facial aesthetic surgery5 (8.1)
      Lower body lift10 (16.1)
      Others7 (11.3)
      Satisfaction with the result(s) of aesthetic surgery*
      Poor12 (19.4)
      Fair24 (38.7)
      Very good24 (38.7)
      Missing2 (3.2)
      How was body contouring surgery paid for?*
      Out of pocket59 (95.2)
      Insurance or government3 (4.8)
      Would consider plastic surgery in the future†
      Yes220 (57.4)
      Desire for body-contouring surgery
      Yes231 (51.9)
      Barriers to body-contouring surgery
      Cost229 (51.5)
      Had no desire72 (16.2)
      Intent to lose more weight33 (7.4)
      Risks of additional surgery64 (14.4)
      Was not recommended by doctors22 (4.7)
      Underwent surgeries before8 (25.0)
      Male doctors3 (9.4)
      Marks after surgery2 (6.3)
      Health problems1 (3.1)
      Need more details1 (3.1)
      Pregnancy1 (3.1)

      Values are presented as numbers and precentages (%).

      • ↵* Responses are based on 62 participants who underwent a body-contouring surgery.

      • ↵† Responses are based on 383 participants who did not undergo a body-contouring surgery.

      • View popup
      Table 3

      - Characteristics of bariatric surgeries.

      ParametersOverall (N=445)Underwent a body contouring surgeryP-values
      No (n=383)Yes (n=62)
      Time since bariatric surgery (year)
      <1 year4 (0.9)4 (1.0)0 (0.0)0.735
      1-2 years49 (11.0)44 (11.5)5 (8.1)
      >2 years392 (88.1)335 (87.5)57 (91.9)
      Type of bariatric surgery
      Gastric sleeve426 (95.7)368 (96.1)58 (93.5)0.208
      Roux-en-y gastric bypass10 (2.2)9 (2.3)1 (1.6)
      Other9 (2.0)6 (1.6)3 (4.8)
      Other types of bariatric surgery*
      Mini bypass2 (22.2)1 (16.7) 0.762
      Re-sleeve1 (11.1)1 (16.7)0 (0.0)
      Re-sleeve then SASI1 (11.1)0 (0.0)1 (33.3)
      SASI5 (55.6)4 (66.7)1 (33.3)
      Change in BMI after bariatric surgery
      Yes-16.6 (-21.1, -13.0)-17.0 (-21.1, -13.3)-14.2 (-20.3, -11.6)0.025
      Time to achieve best weight after bariatric surgery
      After one year or less295 (66.3)265 (69.2)30 (48.4)0.003
      After 2 years118 (26.5)95 (24.8)23 (37.1)
      More than 2 years32 (7.2)23 (6.0)9 (14.5)
      Presence of excess skin fold post bariatric surgery
      Yes317 (71.2)268 (70.0)49 (79.0)0.144

      Values are presented as numbers and precentages (%).

      • ↵* Data was described based on 9 participants who had other types of bariatric surgeries. SASI: stomach aspiration surgical intervention, BMI: body mass index

      • View popup
      Table 4

      - Results of the multivariate regression analysis for the predictors of undergoing body-contouring surgeries.

      ParametersOR95% CIP-values
      Gender
      MaleRefRef 
      Female2.621.34-5.560.008
      Change in BMI after bariatric surgery
      Kg/m21.020.99-1.070.327
      Time to achieve best weight after bariatric surgery
      After one year or lessRefRef 
      After 2 years2.231.21-4.070.009
      More than 2 years3.501.40-8.270.005

      OR: odd ratio, CI: confidence interval, BMI: body mass index

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      Factors and barriers influencing the decision to undergo body contouring surgery after bariatric surgery
      Omar F. Neel, Hatan Mortada, Ghaida AlBraithen, Faisal F. Almutairi, Reem A. Al-Terkawi, Abdelrahman Salem
      Saudi Medical Journal Nov 2023, 44 (11) 1145-1152; DOI: 10.15537/smj.2023.44.11.20230418

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      Factors and barriers influencing the decision to undergo body contouring surgery after bariatric surgery
      Omar F. Neel, Hatan Mortada, Ghaida AlBraithen, Faisal F. Almutairi, Reem A. Al-Terkawi, Abdelrahman Salem
      Saudi Medical Journal Nov 2023, 44 (11) 1145-1152; DOI: 10.15537/smj.2023.44.11.20230418
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      Keywords

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