Background

Abdominoplasty is increasingly performed following successful weight loss from bariatric surgery. The risk of complications after abdominoplasty may be increased in patients who have undergone bariatric surgery compared to those who have not. The known complications are mainly wound-related, such as seroma formation, necrosis, and infection. It is also known that abdominoplasty results in increased intraabdominal pressure, which could theoretically cause or worsen dysphagia or acid reflux by compressing an already at-risk anatomy, such as a narrowed gastric tube after vertical sleeve gastrectomy (VSG). However, the data is sparse on the risk of dysphagia or reflux following abdominoplasty in the bariatric surgery population. We present two patients who developed dysphagia/reflux following abdominoplasty after successful weight loss from a laparoscopic VSG. The first patient is a 38-year-old female who experienced 75% excess weight loss after her VSG. She continued to do well and underwent abdominoplasty approximately 6 years later. She began to complain of dysphagia shortly following the abdominoplasty. Upper gastrointestinal contrast study demonstrated an abrupt angulation at the incisura without complete obstruction (Figure 1). An upper endoscopy demonstrated a twist at the incisura, consistent with the contrast study (Figure 2). The second patient is a 45-year-old female who experienced 42% excess weight loss. She underwent abdominoplasty approximately 2 years after her VSG. She began to complain of acid reflux only after the abdominoplasty. We theorized that the increased intraabdominal pressure from the abdominoplasty changed the anatomy of their sleeves and caused a kink, resulting in dysphagia/reflux.