To Örebro University

BACKGROUND: Obesity is a growing global health problem, and bariatric surgery is an effective treatment for severe obesity. However, massive weight loss frequently results in excess skin and altered breast morphology, resulting in some women seeking implant-based breast surgery. Evidence on the frequency and characteristics of post-bariatric women undergoing breast implant surgery is scarce, with only small case series published. We investigated the prevalence and demographics of such women compared with non-post-bariatric controls.

METHODS: This national population-based case-control study used and linked data from Swedish registries. Women who underwent bariatric surgery (2008-2022) and subsequent benign implant surgery (after 2014) were identified and matched with non-bariatric controls who underwent breast augmentation by age and body mass index. Demographics, comorbidities, and drug data were analyzed and compared between the groups.

RESULTS: Between 2014 and 2024, 817 post-bariatric women underwent breast implant surgery and were compared with 3512 matched controls. The frequency of implant surgery among women with previous bariatric surgery (2008-2013) was 2.8%. Post-bariatric women were more often divorced/separated, had lower education levels, and were more likely to have undergone previous breast or plastic surgery than the controls. They also had higher rates of psychiatric, endocrine, and gastrointestinal comorbidities, reflected in specialist care and prescription data.

CONCLUSION: Post-bariatric women undergoing breast implant surgery constitute a distinct, medically more complex subgroup compared to non-post-bariatric implant patients. Their higher psychosocial vulnerability and comorbidity burden highlight the need for tailored clinical assessment, long-term support, and broader discussion on healthcare access for post-bariatric reconstruction.

PRE-REGISTRATION: Clinicaltrials.gov NCT07059104.