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Heranney J, Lupon E, Guillier D, Feuvrier D, Pluvy I. [Complications and quality of life after bodylift: About 143 patients]. ANN CHIR PLAST ESTH 2023; 68:57-65. [PMID: 36028411 DOI: 10.1016/j.anplas.2022.07.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2022] [Revised: 06/12/2022] [Accepted: 07/06/2022] [Indexed: 01/18/2023]
Abstract
INTRODUCTION The rise of bariatric surgery has led to a considerable increase in the demand for weight loss surgery. The lower body lift consists of removing the residual abdominal fat and skin excess and re-tensioning the surfaces. The objective of our study was to evaluate the associated complications, as well as the consequences of this surgery on the quality of life of the patients. MATERIALS AND METHODS A retrospective monocentric study was conducted in patients operated on for lower body lift between 2010 and 2019 at the University Hospital of Besançon. We collected postoperative complications and studied the satisfaction and quality of life of the operated patients using the Body-QoL and SF-36 questionnaires. RESULTS One hundred forty-three patients were included with a mean age of 41.2 years. The mean body mass index was 26.6kg/m2 with a mean weight of 73.8kg and a mean weight loss of 54.4kg. Forty-one patients (29.7%) had at least one complication. Most complications were minor, with 16.8% of scar disunions, and 7% of complications were major, requiring revision surgery. Ninety-three patients (65%) responded to the satisfaction questionnaires with improvement mostly in physical symptoms and social life. CONCLUSION The lower body lift is an effective, safe procedure with mostly minor complications that do not influence quality of life. Patient satisfaction is high, and it is therefore justified to continue offering this procedure to correct the sequelae of massive weight loss.
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Affiliation(s)
- J Heranney
- Service de chirurgie orthopédique, traumatologique, plastique, reconstructrice et assistance main, CHU Jean-Minjoz, 3, boulevard Fleming, 25030 Besançon cedex, France.
| | - E Lupon
- Service de chirurgie plastique et reconstructrice, hôpital Pasteur 2, CHU de Nice, Nice, France
| | - D Guillier
- Service de chirurgie plastique et maxillo-faciale, CHU, 14, rue Paul-Gaffarel, 21000 Dijon, France
| | - D Feuvrier
- Service de chirurgie orthopédique, traumatologique, plastique, reconstructrice et assistance main, CHU Jean-Minjoz, 3, boulevard Fleming, 25030 Besançon cedex, France
| | - I Pluvy
- Service de chirurgie orthopédique, traumatologique, plastique, reconstructrice et assistance main, CHU Jean-Minjoz, 3, boulevard Fleming, 25030 Besançon cedex, France
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Simunovic F, Bonaventura B, Schneider L, Horner VK, Weber J, Stark GB, Kalash Z. The Edmonton Obesity Staging System Predicts Postoperative Complications After Abdominoplasty. Ann Plast Surg 2021; 87:556-561. [PMID: 34699434 DOI: 10.1097/sap.0000000000002814] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND This study investigates the relationship between Edmonton Obesity Staging System (EOSS) and the occurrence of postoperative complications after abdominoplasty in massive weight loss patients. METHODS A single-institution retrospective review of patients undergoing abdominoplasty between 2009 and 2019 after massive weight loss. Demographic data, laboratory findings, known risk factors for postoperative complications, as well as data on major and minor complications were extracted from the patient charts. Logistic regression models were used to investigate the relationship between the variables. RESULTS Four hundred and five patients were included in the study. The prevalence of EOSS stages was: 0 (no comorbidities, N = 151, 37%), 1 (mild conditions, N = 40, 10%), 2 (moderate conditions, N = 149, 36%) and 3 (severe conditions, N = 70, 17%). Regression analysis showed that, controlling for body mass index (BMI), BMI Δ (maximal BMI - BMI at presentation), bariatric surgery, volume of resected tissue, and duration of surgery, EOSS stage significantly associated with the occurrence of postoperative complications. Compared with EOSS stage 0, EOSS stages 2 and 3 patients were associated with significantly more minor and major complications, respectively. The volume of resected tissue, BMI Δ, and age were associated with the occurrence of major complications. A regression model of comorbidities comprising the EOSS revealed a significant association of variables diabetes mellitus and hypertension with the occurrence of postoperative complications. CONCLUSIONS Edmonton Obesity Staging System is a robust predictor of postoperative complications in abdominoplasty.
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Affiliation(s)
- Filip Simunovic
- From the Department of Plastic and Hand Surgery, Freiburg University Medical Center, Freiburg, Germany
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Soares de Macedo JL, Corrêa Rosa S, Ribeiro Canedo L, Leão CCA, Marques da Silva FM, Farias do Nascimento Rocha JL, Vieira YO, de Rezende Filho Neto AV. The Impact of the Weight of Removed Tissue on the Development of Postoperative Complications in Patients Undergoing Abdominoplasty after Gastric Bypass. Obes Surg 2020; 31:2324-2329. [PMID: 33145721 DOI: 10.1007/s11695-020-05104-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2020] [Revised: 10/27/2020] [Accepted: 10/29/2020] [Indexed: 11/25/2022]
Abstract
BACKGROUND Patients who undergo Roux-en-Y gastric bypass (RYGB) have significant weight loss, and abdominoplasty is an effective corrective surgery for removing excess skin. This study aimed to evaluate the impact of the weight of removed tissue on the development of postoperative complications in patients undergoing abdominoplasty without lipoaspiration after gastric bypass at the Federal District North Wing Regional Hospital, Brasília, Brazil. METHODS Data were analyzed from a prospective registry of patients who underwent abdominoplasty without lipoaspiration after gastric bypass from January 2011 to December 2018. The variables examined included body mass index (BMI) before RYGB and before plastic surgery, weight loss, weight of the excised abdominal flap, comorbidities, and medical complications. Analysis of the role of the weight of the removed tissue after abdominoplasty was performed to assess outcome measures. RESULTS One hundred sixty-three patients were included. The mean age of the patients was 42 years. Their BMI at the time of abdominoplasty was 27.49 kg/m2, and the average weight loss before abdominoplasty was 47.13 kg. The preweight loss BMI was 45.27 kg/m2, and the ∆BMI was 17.78 kg/m2. The overall complication rate was 29.4%. An amount of removed tissue from the abdomen ≥ 2000 g significantly increased the rates of postoperative complications (46.7% vs. 19.4%; p = 0.002; OR = 3.13). CONCLUSIONS Removal of ≥ 2000 g of tissue from the abdomen led to significantly more complications in patients who underwent abdominoplasty after gastric bypass. In addition, this group of patients was significantly associated with the presence of higher anthropometric variable values (BMI, weight loss, max BMI, and ∆BMI) and not associated with the presence of comorbidities.
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Affiliation(s)
- Jefferson Lessa Soares de Macedo
- Department of Plastic and Reconstructive Surgery, Asa Norte Regional Hospital, SQS 213 Bloco H Apto 303, Asa Sul, Brasília, DF, 70 292-080, Brazil. .,Post-Graduation Course in Health Sciences, University of Brasília, Brasília, DF, Brazil. .,Superior School of Health Sciences/FEPECS, Brasília, DF, Brazil.
| | - Simone Corrêa Rosa
- Department of Plastic and Reconstructive Surgery, Asa Norte Regional Hospital, SQS 213 Bloco H Apto 303, Asa Sul, Brasília, DF, 70 292-080, Brazil.,Post-Graduation Course in Health Sciences, University of Brasília, Brasília, DF, Brazil
| | - Lucas Ribeiro Canedo
- Superior School of Health Sciences/FEPECS, Brasília, DF, Brazil.,Department of General Surgery, Asa Norte Regional Hospital, Brasília, DF, Brazil
| | - Cássio Cesar Arrais Leão
- Department of Plastic and Reconstructive Surgery, Asa Norte Regional Hospital, SQS 213 Bloco H Apto 303, Asa Sul, Brasília, DF, 70 292-080, Brazil
| | - Fernando Marinho Marques da Silva
- Department of Plastic and Reconstructive Surgery, Asa Norte Regional Hospital, SQS 213 Bloco H Apto 303, Asa Sul, Brasília, DF, 70 292-080, Brazil
| | - João Lucas Farias do Nascimento Rocha
- Department of Plastic and Reconstructive Surgery, Asa Norte Regional Hospital, SQS 213 Bloco H Apto 303, Asa Sul, Brasília, DF, 70 292-080, Brazil.,Superior School of Health Sciences/FEPECS, Brasília, DF, Brazil.,Department of General Surgery, Asa Norte Regional Hospital, Brasília, DF, Brazil
| | - Yasmine Oliveira Vieira
- Department of Plastic and Reconstructive Surgery, Asa Norte Regional Hospital, SQS 213 Bloco H Apto 303, Asa Sul, Brasília, DF, 70 292-080, Brazil
| | - Altino Vieira de Rezende Filho Neto
- Department of Plastic and Reconstructive Surgery, Asa Norte Regional Hospital, SQS 213 Bloco H Apto 303, Asa Sul, Brasília, DF, 70 292-080, Brazil
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