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"How Do I Look?" Examining Body Image & Contouring Surgery

With the increasing popularity of cosmetic procedures for the body, an important question has arisen: Do these procedures have long-term benefits—and if so, what are they? In a literature review recently published in Aesthetic Surgery Journal, researchers from the College of Public Health examined this question in regards to body contouring surgeries. What they discovered sheds light on these procedures’ potential impact on body image—as well as their limitations—and may help cosmetic surgeons treat patients more effectively.

The review was conducted by David Sarwer, director of Temple’s Center for Obesity Research and Education (CORE), and Heather Polonsky, a graduate student in the Department of Epidemiology and Biostatistics. It analyzed 78 studies of the psychological effects of various body contouring procedures like liposuction and abdominoplasty. “We wanted to bring together what we know on the obesity side of the street and what plastic surgeons deal with when they see patients who struggle with their weight,” Sarwer says.

Many patients who arrive in a surgeon’s office seeking a body contouring procedure are looking to selectively remove a relatively small amount of fat from around their middle—they want to trim their love handles or remove a little pouch from the lower belly, for example. Others have lost a more significant amount of weight already and undergo abdominoplasty, which removes large amounts of loose skin and tightens the underlying muscles.

The researchers found that while liposuction and abdominoplasty patients are often motivated by weight-related issues, many of the benefits of these procedures are not physical, but psychological. “There have been a couple of studies that have asked whether liposuction and abdominoplasty lead to health benefits, and the evidence seems to be that they don’t,” Sarwer says. “We’re seeing that the benefits are more in body image, psychosocial functioning, and comfort with physical appearance, but not in blood pressure and blood sugar.”

The review revealed that body contouring seems effective for addressing specific concerns: About 60 percent of patients don’t seek further treatment. But carryover benefits into overall psychological well-being appear to be limited.

“The evidence is telling us that patients feel better about their physical appearance and body image, but we're not necessarily seeing profound improvements in things like self-esteem and quality of life,” Sarwer says. “They may feel better about the way their abdomen looks, but the procedures don’t lead to promotions at work or help save a romantic relationship.”

Sarwer and Polonsky see this research not only as an opportunity to bring these issues to plastic surgeons who work with patients with a range of body image issues, but also to examine the problem of obesity more holistically—as a condition that affects both body and mind—and as a global public health issue.

“[The project] highlights the fact that the way people see themselves can be quite different from the way others see them,” says Polonsky. “So what can we do to help people be happier on a psychological level? How can changing them on a physical level either help or hinder how they feel or view themselves?”

“Obesity is a growing problem, and I think it definitely contributes to other chronic diseases,” Polonsky adds. “It's an important marker for overall health. So if we're trying to improve the overall health of the population, figuring out ways to help prevent and treat obesity is very important.”

Posted:  September 30, 2016