Obesity Surgery, 16, 673
Correspondence
Body Contouring after Weight Loss in Morbid
Obesity: Gain in Health and Leap in Psychosocial
Functioning
To the Editor:
The importance of an unsatisfactory body image in
causing psychological distress in obese patients has
been recently investigated.1 This psychological distress
encompasses lack of self-esteem, depression,
and tendency to avoid social and sexual relationships.
Body contouring following a significant weight loss
can re-establish a good psychosocial functioning
because of the perception of improved body image.
A 31-year-old morbidly obese man presented to
my plastic surgery clinic for body contouring. He
came accompanied by his mother who held his hand
in a protective and sympathetic manner. As routinely
occurs with these patients, I started describing the
therapeutic path that he should undergo, consisting
of a relevant weight loss first, through diet or
bariatric surgery, followed by multistep body contouring.
2 While I was explaining this to him, I kept
on thinking with human, rather than medical, sympathy
about that 31-year-old man’s hand in his mother’s.
I could not help feeling sadness for a human
being psychologically and socially harmed because
of obesity and with little hope of enjoying an emotional,
social, sexual and familiar normal life.
Years went by, while the patient underwent the
routine procedures of both bariatric and plastic surgery.
While he was under my care, I could gradually
appreciate the progressive gain in body appearance
allowed by body contouring. From an empty baglike
aspect, a more natural human body was returned
to the patient, despite the price of some scars. Plastic
surgery procedures also allowed an improvement of
the buried penis syndrome, which affects both obese
and formerly obese patients’ sexual life.3
Some years after the end of the entire therapeutic
process, 9 years after the first consultation at my
office, I saw this man for a follow-up. While he was
coming to me at the end of a busy clinic, with a
heedless glance I happily noticed that his hand was
no longer in his mother’s. After a more careful
examination, I realized that the woman beside him
was far younger than his mother. “I introduce you to
my wife” he said “and here is my daughter” he
added, caressing his wife’s abdomen.
Giacomo Datta, MD, Consultant Plastic Surgeon;
Filippo Boriani, MD, Fabrizio D. Obbialero, MD,
Maurizio Verga, MD, Residents in Plastic Surgery;
Department of Plastic Surgery,
University of Turin, Turin, Italy.
E-mail:
filippo.boriani@fastwebnet.it
References
1. Friedman KE, Reichmann SK, Costanzo PR et al.
Body image partially mediates the relationship
between obesity and psychological distress. Obes Res
2002; 10: 33-41.
2. Datta G, Cravero L, Margara A et al. The plastic surgeon
in the treatment of obesity. Obes Surg 2006; 16: 5-11.
3. Fontana D, Rolle L, Ceruti C et al. [False penile shortness][
Article in Italian] Arch Ital Urol Androl 1998;
70, 241-5.
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