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Nutritional Deficiency of Post-Bariatric Surgery Body Contouring Patients: What Every Plastic Surgeon Should Know

Agha-Mohammadi, Siamak M.B., B.Chir., Ph.D.; Hurwitz, Dennis J. M.D.

Plastic and Reconstructive Surgery: August 2008 - Volume 122 - Issue 2 - p 604-613
doi: 10.1097/PRS.0b013e31817d6023

Background: Bariatric surgery, particularly the Roux-en-Y gastric bypass, is currently the most effective method of sustainable weight loss for the morbidly obese patient population. Unfortunately, the nutritional adequacy of the postoperative diet has frequently been overlooked, and in the months to years that follow, many nutritional deficiencies have become apparent. Furthermore, once weight loss has reached a plateau, many patients become candidates for body contouring surgery and other aesthetic operations.

Methods: The aim of this review was to highlight the nutritional deficiencies of post-bariatric surgery patients as related to planned body contouring surgery. This review was prepared by an extensive search of the bariatric surgery literature.

Results: The current data indicate that many post-bariatric surgery patients have protein-calorie malnutrition as well as various vitamins and mineral deficiencies that may limit optimal health and healing.

Conclusions: It is essential that those plastic surgeons who treat post-bariatric surgery patients are aware of these nutritional deficiencies, which can be minimized by adhering to eating guidelines and supplemental prescriptions. Although there are many studies documenting relationships between malnutrition and poor wound healing, the optimal nutrient intake in the post-bariatric surgery state to promote wound healing is unknown. It is, however, clear that proteins, vitamin A, vitamin C, arginine, glutamine, zinc, and selenium have significant beneficial effects on wound healing and optimizing the immune system.

Pittsburgh, Pa.

From the Hurwitz Center for Plastic Surgery.

Received for publication August 1, 2007; accepted December 14, 2007.

Disclosure: None of the authors has a financial interest in any of the products, devices, or drugs mentioned in this article.

Siamak Agha-Mohammadi, M.B., B.Chir., Ph.D., Plastic Surgery and Body Contouring Center, 400 Newport Center Drive, Suite 500, Newport Beach, Calif. 92660,

©2008American Society of Plastic Surgeons