{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,16]],"date-time":"2026-03-16T10:02:18Z","timestamp":1773655338769,"version":"3.50.1"},"reference-count":68,"publisher":"MJS Publishing, Medical Journals Sweden AB","license":[{"start":{"date-parts":[[2026,3,16]],"date-time":"2026-03-16T00:00:00Z","timestamp":1773619200000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JPHS"],"abstract":"<jats:p>Excess skin after massive weight loss is especially discomforting on the abdomen due to physical and psychosocial symptoms, and many patients with excess skin have a lowered Quality of Life (QoL). Abdominoplasty may improve symptoms as well as QoL and is offered to post-bariatric patients in Sweden with a post-\u00adoperative body mass index (BMI) &lt;\u200930 kg\/m2. However, since &gt;\u200950% never reach a BMI &lt;\u200930, they are often left with an abdominal pannus that may hinder further weight loss. The reluctance to operate on patients with BMI &gt;\u200930 is the increased risk of complications reported in several studies. Contradictorily, many studies have not found BMI &gt;\u200930 to be an independent risk factor. Thus, the aim of this study was to prospectively evaluate a modified abdominoplasty technique on patients with a residual BMI 30\u201340, regarding complications and patient satisfaction. To contextualize, this was compared to a group of post-bariatric patients with a BMI &lt;\u200930 that underwent standard abdominoplasties. A total of 110 patients underwent either a standard abdominoplasty (BMI &lt;\u200930 group) or a modified abdominoplasty (BMI 30\u201340 group). Pre-, peri-, and post-operative data were analyzed. The complication rates were similar, apart from that the patients with BMI 30\u201340 had significantly more bleedings requiring re-interventions. There were no other significant differences in the complication panorama. The results from the questionnaires implied significant improvements in QoL and perception of excess skin, particularly in the BMI 30\u201340 group. In conclusion, this modified technique for abdominoplasty may be an acceptable compromise to a standard abdominoplasty for post-bariatric patients with residual obesity.Clinical trials registry: https:\/\/www.researchweb.org\/is\/sverige\/project\/203961.<\/jats:p>","DOI":"10.2340\/jphs.v61.45541","type":"journal-article","created":{"date-parts":[[2026,3,16]],"date-time":"2026-03-16T09:10:02Z","timestamp":1773652202000},"page":"24-34","source":"Crossref","is-referenced-by-count":0,"title":["Evaluation of modified abdominoplasty for excess skin in post-bariatric surgery patients with residual obesity"],"prefix":"10.2340","volume":"61","author":[{"given":"Jonas","family":"Ockell","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christina","family":"Bi\u00f6rserud","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Monika","family":"Fagevik Ols\u00e9n","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anna","family":"Elander","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1183","published-online":{"date-parts":[[2026,3,16]]},"reference":[{"key":"144472","doi-asserted-by":"crossref","unstructured":"Biorserud C, Nielsen C, Staalesen T, et al. Sahlgrenska Excess Skin Questionnaire (SESQ): a reliable questionnaire to assess the experience of excessive skin after weight loss. J Plast Surg Hand Surg. 2013;47(1):50\u201359.","DOI":"10.3109\/2000656X.2012.731001"},{"key":"144473","doi-asserted-by":"crossref","unstructured":"https:\/\/doi.org\/10.3109\/2000656X.2012.731001","DOI":"10.3109\/2000656X.2012.731001"},{"key":"144474","doi-asserted-by":"crossref","unstructured":"Klassen AF, Kaur M, Breitkopf T, et al. Using the BODY-Q to understand impact of weight loss, excess skin, and the need for body contouring following bariatric surgery. Plast Reconstr Surg. 2018;142(1):77\u201386.","DOI":"10.1097\/PRS.0000000000004461"},{"key":"144475","doi-asserted-by":"crossref","unstructured":"https:\/\/doi.org\/10.1097\/PRS.0000000000004461","DOI":"10.1097\/PRS.0000000000004461"},{"key":"144476","doi-asserted-by":"crossref","unstructured":"Elander A, Biorserud C, Staalesen T, et al. Aspects of excess skin in obesity, after weight loss, after body contouring surgery and in a reference population. Surg Obes Relat Dis. 2019;15(2):305\u2013311.","DOI":"10.1016\/j.soard.2018.10.032"},{"key":"144477","doi-asserted-by":"crossref","unstructured":"https:\/\/doi.org\/10.1016\/j.soard.2018.10.032","DOI":"10.1016\/j.soard.2018.10.032"},{"key":"144478","doi-asserted-by":"crossref","unstructured":"Biorserud C, Olbers T, Staalesen T, et al. Understanding excess skin in postbariatric patients: objective measurements and subjective experiences. Surg Obes Relat Dis. 2016;12(7):1410\u20131417.","DOI":"10.1016\/j.soard.2016.01.033"},{"key":"144479","doi-asserted-by":"crossref","unstructured":"https:\/\/doi.org\/10.1016\/j.soard.2016.01.033","DOI":"10.1016\/j.soard.2016.01.033"},{"key":"144480","doi-asserted-by":"crossref","unstructured":"Magallares A, Schomerus G. Mental and physical health-related quality of life in obese patients before and after bariatric surgery: a meta-analysis. Psychol Health Med. 2015;20(2):165\u2013176.","DOI":"10.1080\/13548506.2014.963627"},{"key":"144481","doi-asserted-by":"crossref","unstructured":"https:\/\/doi.org\/10.1080\/13548506.2014.963627","DOI":"10.1080\/13548506.2014.963627"},{"key":"144482","doi-asserted-by":"crossref","unstructured":"Driscoll S, Gregory DM, Fardy JM, et al. Long-term health-related quality of life in bariatric surgery patients: a systematic review and meta-analysis. Obesity (Silver Spring, Md). 2016;24(1):60\u201370.","DOI":"10.1002\/oby.21322"},{"key":"144483","doi-asserted-by":"crossref","unstructured":"https:\/\/doi.org\/10.1002\/oby.21322","DOI":"10.1002\/oby.21322"},{"key":"144484","doi-asserted-by":"crossref","unstructured":"Klassen AF, Cano SJ, Scott A, et al. Satisfaction and quality-of-life issues in body contouring surgery patients: a qualitative study. Obes Surg. 2012;22(10):1527\u20131534.","DOI":"10.1007\/s11695-012-0640-1"},{"key":"144485","doi-asserted-by":"crossref","unstructured":"https:\/\/doi.org\/10.1007\/s11695-012-0640-1","DOI":"10.1007\/s11695-012-0640-1"},{"key":"144486","doi-asserted-by":"crossref","unstructured":"Sadeghi P, Duarte-Bateman D, Ma W, et al. Post-bariatric plastic surgery: abdominoplasty, the state of the art in body contouring. J Clin Med. 2022;11(15):4315.","DOI":"10.3390\/jcm11154315"},{"key":"144487","doi-asserted-by":"crossref","unstructured":"https:\/\/doi.org\/10.3390\/jcm11154315","DOI":"10.3390\/jcm11154315"},{"key":"144488","doi-asserted-by":"crossref","unstructured":"Jiang Z, Zhang G, Huang J, et al. A systematic review of body contouring surgery in post-bariatric patients to determine its prevalence, effects on quality of life, desire, and barriers. Obes Rev. 2021;22(5):e13201.","DOI":"10.1111\/obr.13201"},{"key":"144489","doi-asserted-by":"crossref","unstructured":"https:\/\/doi.org\/10.1111\/obr.13201","DOI":"10.1111\/obr.13201"},{"key":"144490","doi-asserted-by":"crossref","unstructured":"Toma T, Harling L, Athanasiou T, et al. Does body contouring after bariatric weight loss enhance quality of life? A systematic review of QOL studies. Obes Surg. 2018;28(10):3333\u20133341.","DOI":"10.1007\/s11695-018-3323-8"},{"key":"144491","doi-asserted-by":"crossref","unstructured":"https:\/\/doi.org\/10.1007\/s11695-018-3323-8","DOI":"10.1007\/s11695-018-3323-8"},{"key":"144492","doi-asserted-by":"crossref","unstructured":"arban OA, Cassidy RB, Bonham A, et al. Factors associated with achieving a body mass ndex of less than 30 after bariatric surgery. JAMA Surg. 2017;152(11):1058\u20131064. ttps:\/\/doi.org\/10.1001\/jamasurg.2017.2348","DOI":"10.1001\/jamasurg.2017.2348"},{"key":"144493","doi-asserted-by":"crossref","unstructured":"Froylich D, Corcelles R, Daigle CR, et al. Weight loss is higher among patients who undergo body contouring procedures after bariatric surgery. Surg Obes Relat Dis. 2016;12(9):1731\u20131736.","DOI":"10.1016\/j.soard.2015.09.009"},{"key":"144494","doi-asserted-by":"crossref","unstructured":"https:\/\/doi.org\/10.1016\/j.soard.2015.09.009","DOI":"10.1016\/j.soard.2015.09.009"},{"key":"144495","doi-asserted-by":"crossref","unstructured":"Sandvik J, Hole T, Kl\u00f6ckner C, et al. The impact of post-\u00adbariatric abdominoplasty on secondary weight regain after Roux-en-Y Gastric Bypass. Front Endocrinol (Lausanne). 2020;11:459.","DOI":"10.3389\/fendo.2020.00459"},{"key":"144496","doi-asserted-by":"crossref","unstructured":"https:\/\/doi.org\/10.3389\/fendo.2020.00459","DOI":"10.3389\/fendo.2020.00459"},{"key":"144497","doi-asserted-by":"crossref","unstructured":"Rocic P. Comparison of cardiovascular benefits of \u00adbariatric surgery and abdominal lipectomy. Curr Hypertens Rep. 2019;21(5):37.","DOI":"10.1007\/s11906-019-0945-8"},{"key":"144498","doi-asserted-by":"crossref","unstructured":"https:\/\/doi.org\/10.1007\/s11906-019-0945-8","DOI":"10.1007\/s11906-019-0945-8"},{"key":"144499","unstructured":"Cuomo R, Russo F, Sisti A, et al. Abdominoplasty in mildly obese patients (BMI 30-35 kg\/m2): metabolic, biochemical and complication analysis at one year. In vivo (Athens, Greece). 2015;29(6):757\u2013761."},{"key":"144500","doi-asserted-by":"crossref","unstructured":"Rogliani M, Silvi E, Labardi L, et al. Obese and nonobese patients: complications of abdominoplasty. Ann Plast Surg. 2006;57(3):336\u2013338.","DOI":"10.1097\/01.sap.0000221460.43861.6b"},{"key":"144501","doi-asserted-by":"crossref","unstructured":"https:\/\/doi.org\/10.1097\/01.sap.0000221460.43861.6b","DOI":"10.1097\/01.sap.0000221460.43861.6b"},{"key":"144502","doi-asserted-by":"crossref","unstructured":"Kalmar CL, Park BC, Kassis S, et al. Functional panniculectomy vs cosmetic abdominoplasty: multicenter analysis of risk factors and complications. J Plast Reconstr Aesth Surg. 2022;75(9):3541\u20133550.","DOI":"10.1016\/j.bjps.2022.04.057"},{"key":"144503","doi-asserted-by":"crossref","unstructured":"https:\/\/doi.org\/10.1016\/j.bjps.2022.04.057","DOI":"10.1016\/j.bjps.2022.04.057"},{"key":"144504","doi-asserted-by":"crossref","unstructured":"Schlosshauer T, Kiehlmann M, Jung D, et al. Post-bariatric abdominoplasty: analysis of 406 cases with focus on risk factors and complications. Aesth Surg J. 2021;41(1):59\u201371.","DOI":"10.1093\/asj\/sjaa067"},{"key":"144505","doi-asserted-by":"crossref","unstructured":"https:\/\/doi.org\/10.1093\/asj\/sjaa067","DOI":"10.1093\/asj\/sjaa067"},{"key":"144506","doi-asserted-by":"crossref","unstructured":"Christopher AN, Morris MP, Patel V, et al. Abdominal body contouring: does body mass index affect clinical and patient reported outcomes? J Surg Res. 2022;270:348\u2013358.","DOI":"10.1016\/j.jss.2021.09.035"},{"key":"144507","doi-asserted-by":"crossref","unstructured":"https:\/\/doi.org\/10.1016\/j.jss.2021.09.035","DOI":"10.1016\/j.jss.2021.09.035"},{"key":"144508","doi-asserted-by":"crossref","unstructured":"de Macedo JLS, Rosa SC, Canedo LR, et al. What is the impact of residual obesity on the risk for postoperative body-\u00adcontouring surgery complications in postbariatric patients? Obes Surg. 2020;30(10):4149\u20134154.","DOI":"10.1007\/s11695-020-04711-0"},{"key":"144509","doi-asserted-by":"crossref","unstructured":"https:\/\/doi.org\/10.1007\/s11695-020-04711-0","DOI":"10.1007\/s11695-020-04711-0"},{"key":"144510","doi-asserted-by":"crossref","unstructured":"Hasanbegovic E, Sorensen JA. Complications following body contouring surgery after massive weight loss: a meta-analysis. J Plast Reconstr Aesth Surg. 2014;67(3):295\u2013301.","DOI":"10.1016\/j.bjps.2013.10.031"},{"key":"144511","doi-asserted-by":"crossref","unstructured":"https:\/\/doi.org\/10.1016\/j.bjps.2013.10.031","DOI":"10.1016\/j.bjps.2013.10.031"},{"key":"144512","doi-asserted-by":"crossref","unstructured":"Staalesen T, Olsen MF, Elander A. Complications of abdominoplasty after weight loss as a result of bariatric surgery or dieting\/postpregnancy. J Plast Surg Hand Surg. 2012;46(6):416\u201320.","DOI":"10.3109\/2000656X.2012.717898"},{"key":"144513","doi-asserted-by":"crossref","unstructured":"https:\/\/doi.org\/10.3109\/2000656X.2012.717898","DOI":"10.3109\/2000656X.2012.717898"},{"key":"144514","doi-asserted-by":"crossref","unstructured":"Friedman T, O\u2019Brien Coon D, Michaels J, et al. Fleur-de-Lis abdominoplasty: a safe alternative to traditional abdominoplasty for the massive weight loss patient. Plast Reconstr Surg. 2010;125(5):1525\u20131535.","DOI":"10.1097\/PRS.0b013e3181d6e7e0"},{"key":"144515","doi-asserted-by":"crossref","unstructured":"https:\/\/doi.org\/10.1097\/PRS.0b013e3181d6e7e0","DOI":"10.1097\/PRS.0b013e3181d6e7e0"},{"key":"144516","doi-asserted-by":"crossref","unstructured":"Gunnarson GL, Froyen JK, Sandbu R, et al. Plastic surgery after bariatric surgery. Tidsskr Nor Laegeforen. 2015;135(11):1044\u20131049.","DOI":"10.4045\/tidsskr.14.0814"},{"key":"144517","doi-asserted-by":"crossref","unstructured":"https:\/\/doi.org\/10.4045\/tidsskr.14.0814","DOI":"10.4045\/tidsskr.14.0814"},{"key":"144518","doi-asserted-by":"crossref","unstructured":"Ockell J, Elander A, Staalesen T, et al. Evaluation of excess skin in Swedish adults 18-59 years of age. J Plast Surg Hand Surg. 2017;51(2):99\u2013104.","DOI":"10.1080\/2000656X.2016.1187157"},{"key":"144519","doi-asserted-by":"crossref","unstructured":"https:\/\/doi.org\/10.1080\/2000656X.2016.1187157","DOI":"10.1080\/2000656X.2016.1187157"},{"key":"144520","doi-asserted-by":"crossref","unstructured":"Burstr\u00f6m K, Sun S, Gerdtham UG, et al. Swedish experience-based value sets for EQ-5D health states. Qual Life Res. 2014;23(2):431\u2013442.","DOI":"10.1007\/s11136-013-0496-4"},{"key":"144521","doi-asserted-by":"crossref","unstructured":"https:\/\/doi.org\/10.1007\/s11136-013-0496-4","DOI":"10.1007\/s11136-013-0496-4"},{"key":"144522","doi-asserted-by":"crossref","unstructured":"Zigmond AS, Snaith RP. The hospital anxiety and depression scale. Acta Psychiatr Scand. 1983;67(6):361\u2013370.","DOI":"10.1111\/j.1600-0447.1983.tb09716.x"},{"key":"144523","doi-asserted-by":"crossref","unstructured":"https:\/\/doi.org\/10.1111\/j.1600-0447.1983.tb09716.x","DOI":"10.1111\/j.1600-0447.1983.tb09716.x"},{"key":"144524","doi-asserted-by":"crossref","unstructured":"Nicholas P, Hefford C, Tumilty S. The use of the Patient-Specific Functional Scale to measure rehabilitative progress in a physiotherapy setting. J Man Manip Ther. 2012;20(3):147\u2013152.","DOI":"10.1179\/2042618612Y.0000000006"},{"key":"144525","doi-asserted-by":"crossref","unstructured":"https:\/\/doi.org\/10.1179\/2042618612Y.0000000006","DOI":"10.1179\/2042618612Y.0000000006"},{"key":"144526","doi-asserted-by":"crossref","unstructured":"Lewin R, G\u00f6ransson M, Elander A, et al. Risk factors for complications after breast reduction surgery. J Plast Surg Hand Surg. 2014;48(1):10\u201314.","DOI":"10.3109\/2000656X.2013.791625"},{"key":"144527","doi-asserted-by":"crossref","unstructured":"https:\/\/doi.org\/10.3109\/2000656X.2013.791625","DOI":"10.3109\/2000656X.2013.791625"},{"key":"144528","doi-asserted-by":"crossref","unstructured":"De Paep K, Van Campenhout I, Van Cauwenberge S, Dillemans B. Post-bariatric abdominoplasty: identification of risk factors for complications. Obes Surg. 2021;31(7):3203\u20133209.","DOI":"10.1007\/s11695-021-05383-0"},{"key":"144529","doi-asserted-by":"crossref","unstructured":"https:\/\/doi.org\/10.1007\/s11695-021-05383-0","DOI":"10.1007\/s11695-021-05383-0"},{"key":"144530","unstructured":"Griffin M, Akhavani MA, Muirhead N, et al. Risk of thromboembolism following body-contouring surgery after massive weight loss. Eplasty. 2015;15:e17."},{"key":"144531","doi-asserted-by":"crossref","unstructured":"Gupta V, Winocour J, Rodriguez-Feo C, et al. Safety of aesthetic surgery in the overweight patient: analysis of 127,961 patients. Aesth Surg J. 2016;36(6):718\u2013729.","DOI":"10.1093\/asj\/sjv268"},{"key":"144532","doi-asserted-by":"crossref","unstructured":"https:\/\/doi.org\/10.1093\/asj\/sjv268","DOI":"10.1093\/asj\/sjv268"},{"key":"144533","doi-asserted-by":"crossref","unstructured":"Kalmar CL, Thayer WP, Kassis S, et al. Pulmonary embolism risk after cosmetic abdominoplasty and functional panniculectomy. Ann Plast Surg. 2022;89(6):664\u2013669.","DOI":"10.1097\/SAP.0000000000003281"},{"key":"144534","doi-asserted-by":"crossref","unstructured":"https:\/\/doi.org\/10.1097\/SAP.0000000000003281","DOI":"10.1097\/SAP.0000000000003281"},{"key":"144535","doi-asserted-by":"crossref","unstructured":"Reish RG, Damjanovic B, Colwell AS. Deep venous thrombosis prophylaxis in body contouring: 105 consecutive patients. Ann Plast Surg. 2012;69(4):412\u2013414.","DOI":"10.1097\/SAP.0b013e31824a45e0"},{"key":"144536","doi-asserted-by":"crossref","unstructured":"https:\/\/doi.org\/10.1097\/SAP.0b013e31824a45e0","DOI":"10.1097\/SAP.0b013e31824a45e0"},{"key":"144537","doi-asserted-by":"crossref","unstructured":"[35] Brito \u00cdM, Meireles R, Baltazar J, et al. Abdominoplasty and patient safety: the impact of body mass index and bariatric surgery on complications profile. Aesth Plast Surg. 2020;44(5):1615\u20131624. https:\/\/doi.org\/10.1007\/s00266-020-01725-y","DOI":"10.1007\/s00266-020-01725-y"},{"key":"144538","doi-asserted-by":"crossref","unstructured":"Teni FS, Gerdtham UG, Leidl R, et al. Inequality and heterogeneity in health-related quality of life: findings based on a large sample of cross-sectional EQ-5D-5L data from the Swedish general population. Qual Life Res. 2022;31(3):697\u2013712.","DOI":"10.1007\/s11136-021-02982-3"},{"key":"144539","doi-asserted-by":"crossref","unstructured":"https:\/\/doi.org\/10.1007\/s11136-021-02982-3","DOI":"10.1007\/s11136-021-02982-3"}],"container-title":["Journal of Plastic Surgery and Hand Surgery"],"original-title":[],"link":[{"URL":"https:\/\/medicaljournalssweden.se\/JPHS\/article\/download\/45541\/53152","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/medicaljournalssweden.se\/JPHS\/article\/download\/45541\/53152","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,3,16]],"date-time":"2026-03-16T09:10:27Z","timestamp":1773652227000},"score":1,"resource":{"primary":{"URL":"https:\/\/medicaljournalssweden.se\/JPHS\/article\/view\/45541"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,3,16]]},"references-count":68,"URL":"https:\/\/doi.org\/10.2340\/jphs.v61.45541","relation":{},"ISSN":["2000-6764"],"issn-type":[{"value":"2000-6764","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,3,16]]}}}