Body Contouring of Breast and Abdomen with Belt Dermolipectomy after Massive Weight Loss: A Case Report

Purpose: Obese proportion is increasing universally, estimating more than a billion. So reducing the weight became one of the topic in medical market. Not only diet, exercise, medication, but also many surgical procedures are being developed, such as sleeve gastrectomy, gastric bypass surgery. After massive weight loss, skin excess and laxity occurs, leading to unsatisfying body contour. Body contouring surgery including abdominoplasty, breast reduction is performed when skin excess is present in abdomen and breast. When skin excess is present circumferentially, belt dermolipectomy is the treatment of choice. Methods: A 23-year-old man had weight gain since he was 12 of age. A year before visiting to our department, his height was 168 cm, weight was 150 kg and body mass index (BMI) was 53.15 kg/$m^2$. The patient lost 55 kg of his weight through exercise and diet control. When he visited again, his weight was 95 kg and BMI was 33.66 kg/$m^2$. In physical examination, skin excess and laxity was seen in both breast and abdomen circumferentially and lateral folds were seen in the back. Abdominal contour deformity (Pitman classification type 6) and pseudogynecomastia (grade 3) were present in both breast. Belt dermolipectomy of abdomen, both breast and lateral folds was performed, resecting 6,400 g of tissue and additive 1,200 g through revisional operation. Results: The patient lost 6,500g of his weight and BMI reduced by 2.3 kg/$m^2$. The patient's hospital course was uneventful during 5 weeks of hospitalization and he was satisfied with his final body contour. Conclusion: Body contouring with belt dermolipectomy in patient who has circumferential skin excess and laxity after massive weight loss can be a treatment of choice.

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