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Daneshi K, Mansour HRK, Pacheco-Barrios N, Asaju A, Pérez Pachon M, Hoyos A, Khajuria A. A Bibliometric Analysis of the Top 100 Papers on Gluteal Augmentation. Aesthet Surg J Open Forum 2024; 6:ojae053. [PMID: 39100865 PMCID: PMC11295219 DOI: 10.1093/asjof/ojae053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/06/2024] Open
Abstract
Background Gluteoplasty or gluteal augmentation is a popular cosmetic procedure that is used to improve the volume, shape, and contour of the buttocks. Objectives This bibliometric analysis aims to characterize emerging research trends and to assess the methodological quality of the highest impact gluteoplasty research. Methods The 100 most-cited publications in gluteoplasty were identified on Web of Science, across all available journal years (from Inception to August 2023). Study details, including the citation count, main content focus, and outcome measures, were extracted and tabulated from each publication. Oxford Centre for Evidence Based Medicine level of evidence (LOE) of each study was assessed. Results The 100 most-cited publications regarding gluteoplasty were cited by a total of 2375 publications. Citations per publication ranged from 5 to 176 (mean 23.75 ± 25.86), with the highest-cited study being authored by Simonacci, discussing autologous fat grafting (n = 176). Most publications were LOE 5 (n = 55), representative of the large number of case series and reports. The number of publications for LOE 1, 2, 3, and 4 was 1, 9, 13, and 22, respectively. The main content focus was "surgical technique" in 38 publications, followed by "outcomes" (n = 34) and "risk factors/prognosis" (n = 10). Patient-reported outcome measures (PROMs) were used in 20 publications, and 33 publications reported aesthetic outcome measures. Conclusions This analysis demonstrates a need for improvement in research methodologies regarding gluteoplasty research. This advancement would be facilitated by robust, high-quality research through randomized control trials and multicenter studies, as well as the further development of validated PROMs for gluteoplasty. Level of Evidence 2
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Affiliation(s)
| | | | | | | | | | | | - Ankur Khajuria
- Corresponding Author: Dr Ankur Khajuria, Department of Surgery and Cancer, London W2 1NY, UK. E-mail:
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2
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Bouhadana G, ElHawary H, Alam P, Gilardino MS. A Procedure and Complication-Specific Assessment of Smoking in Aesthetic Surgery: A Systematic Review and Meta-Analysis. Plast Surg (Oakv) 2024; 32:115-126. [PMID: 38433792 PMCID: PMC10902487 DOI: 10.1177/22925503221085083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/05/2024] Open
Abstract
Background: The popularity of aesthetic surgery is on the rise, as is patients' expectations towards excellent surgical results. In order to meet these expectations, risk factors that hinder desired outcomes, such as smoking, need to be identified and addressed. To that end, the present study summarizes an updated systematic review focused on the effects of smoking on cosmetic surgical procedures and outcomes. Methods: A systematic review of studies comparing aesthetic surgical outcomes by procedure, between tobacco smokers and non-smokers was carried out, querying PubMed, Embase and the Cochrane databases. Data regarding surgical outcomes were extracted and meta-analyzed by a random effects model in conjunction with the Mantel-Haenszel statistical method. Results: Eighty-two studies were included in the final synthesis. Abdominoplasty/panniculectomy (n = 19 cohorts) and breast reduction (n = 27 cohorts) were the most common types of procedures included in this review. Other than mastopexy and rhinoplasty, smoking conferred a statistically significant increased risk of overall complications for all studied aesthetic procedures. Conclusions: The data demonstrates that smoking is a clear risk factor for the vast majority of aesthetic plastic surgeries studied. Although our meta-analysis suggests that smoking is not a risk factor for complications in mastopexies and rhinoplasties, these two specific analyses may have been biased, and should therefore be re-evaluated with future additional evidence. The results of this systematic review confirm the importance of smoking cessation and education relative to the outcomes of common cosmetic surgical procedures.
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Affiliation(s)
| | - Hassan ElHawary
- Division of Plastic and Reconstructive Surgery, McGill University Health Centre, Montreal, Quebec, Canada
| | - Peter Alam
- Division of Plastic and Reconstructive Surgery, McGill University Health Centre, Montreal, Quebec, Canada
| | - Mirko S. Gilardino
- Division of Plastic and Reconstructive Surgery, McGill University Health Centre, Montreal, Quebec, Canada
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Wilson A, Raafat S. One key to fit all locks? Routine internal drainage to minimize seromas during thigh lift surgeries. ANN CHIR PLAST ESTH 2022; 67:153-161. [DOI: 10.1016/j.anplas.2022.02.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Revised: 01/24/2022] [Accepted: 02/24/2022] [Indexed: 11/26/2022]
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Safety and efficacy of gluteal contouring based on stromal enriched lipograft in 194 patients. EUROPEAN JOURNAL OF PLASTIC SURGERY 2021. [DOI: 10.1007/s00238-021-01912-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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5
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Lipo-Bodylift Reconstruction Following Massive Weight Loss: Our Experience with 100 Consecutive Cases. Aesthetic Plast Surg 2021; 45:2220-2228. [PMID: 33492477 DOI: 10.1007/s00266-020-02118-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2020] [Accepted: 12/26/2020] [Indexed: 12/29/2022]
Abstract
BACKGROUND We report our experience using the Lipo-Bodylift technique for circumferential lower trunk reconstruction following massive weight loss. METHODS The procedure combines extensive circular liposuction with circular skin resection immediately under the dermis. We classify lower trunk deformities using three parameters: (1) excess skin (in the horizontal direction, or both horizontally and vertically); (2) the body mass index (BMI); and, (3) skin quality (hyperlaxity or a normal tone). All patients can be divided into four groups, of whom groups I and II are the best candidates for the Lipo-Bodylift procedure. We also describe our perioperative management and patient outcomes, with a focus on postoperative complications. RESULTS Between January 2015 and January 2020, 100 patients underwent Lipo-Bodylift treatment. The median patient age was 41 years. The median preoperative BMI was 26.3 kg/m2. The median drainage duration and hospital stay were both 3 days. Of all patients, 30% experienced at least one complication, 2% of which were major. Of the minor complications, 27 patients evidenced wound dehiscence. Only (positive) smoking status was significantly associated with postoperative complications (p < 0.001). CONCLUSION We developed the Lipo-Bodylift technique after analyzing changes in the skin and subcutaneous fat after massive weight loss. The technique completes the arsenal of body contouring techniques, appears to be less invasive than the undermining that is usually performed during circumferential reconstruction of the lower trunk, and is associated with a lower rate of major complications. LEVEL OF EVIDENCE IV This journal requires that authors assign a level of evidence to each article. For a full description of these evidence-based Medicine ratings, please refer to Table of Contents or the online Instructions to Authors www.springer.com/00266.
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Royer E, Hersant B, Philandrianos C, Jaloux C, Casanova D, Bertrand B. Post-Bariatric Buttock Contouring With Gluteal Implants During Circumferential Body Lift: Step-By-Step Video Description and 1-Year Results. Aesthet Surg J 2019; 39:233-237. [PMID: 30395184 DOI: 10.1093/asj/sjy212] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
| | - Barbara Hersant
- Department of Maxillofacial and Plastic, Reconstructive, and Aesthetic Surgery, at the Henri Mondor Hospital, Créteil, Assistance Publique - Hôpitaux de Paris, France
| | - Cécile Philandrianos
- Department of Plastic Surgery, at the La Conception Hospital, Assistance Publique - Hôpitaux de Marseille, Marseille, France
| | - Charlotte Jaloux
- Department of Plastic Surgery, at the La Conception Hospital, Assistance Publique - Hôpitaux de Marseille, Marseille, France
| | - Dominique Casanova
- Department of Plastic Surgery, at the La Conception Hospital, Assistance Publique - Hôpitaux de Marseille, Marseille, France
| | - Baptiste Bertrand
- Department of Plastic Surgery, at the La Conception Hospital, Assistance Publique - Hôpitaux de Marseille, Marseille, France
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7
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Li DQ, Lu GM, Liang YD, Liang ZJ, Huang MH, Peng QL, Zou DH, Gu RH, Xu FT, Gao H, Chen ZD, Chi GY, Wei ZH, Chen L, Li HM. CD54+ rabbit adipose-derived stem cells overexpressing HIF-1α facilitate vascularized fat flap regeneration. Oncotarget 2018; 8:46875-46890. [PMID: 28423354 PMCID: PMC5564529 DOI: 10.18632/oncotarget.16777] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2017] [Accepted: 03/22/2017] [Indexed: 01/22/2023] Open
Abstract
Fat flap transplantation is frequently performed in patients suffering from soft tissue defects resulting from disease or trauma. This study explored the feasibility of constructing vascularized fat flaps using rabbit adipose-derived stem cells (rASCs) and collagen scaffolds in a rabbit model. We evaluated rASCs proliferation, paracrine function, adipogenesis, vascularization, and CD54 expression, with or without HIF-1α transfection in vitro and in vivo. We observed that adipogenic differentiation potential was greater in rASCs with high CD54 expression (CD54+rASCs) than in those with low expression (CD54–rASCs), both in vitro and in vivo. HIF-1α overexpression not only augmented this effect, but also enhanced cell proliferation and paracrine function in vitro. We also demonstrated that HIF-1α-transfected CD54+rASCs showed enhanced paracrine function and adipogenic capacity, and that paracrine function increases expression of angiogenesis-related markers. Thus, CD54+rASCs overexpressing HIF-1α enhanced large volume vascularized fat flap regeneration in rabbits, suggesting CD54 may be an ideal candidate marker for ASCs adipogenic differentiation.
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Affiliation(s)
- De-Quan Li
- Department of Mammary Glands Surgery, The Third Hospital of Nanchang City, Nanchang 330009, China
| | - Guan-Ming Lu
- Department of Glands Surgery, The Affiliated Hospital of Youjiang Medical University for Nationalities, Baise 533000, China
| | - Yi-Dan Liang
- Central Laboratory of Medical Science, The Fifth Affiliated Hospital of Guangxi Medical University, Nanning 530022, China
| | - Zhi-Jie Liang
- Department of Mammary Glands Surgery, The Fifth Affiliated Hospital of Guangxi Medical University, Nanning 530022, China
| | - Min-Hong Huang
- Department of Mammary Glands Surgery, The Fifth Affiliated Hospital of Guangxi Medical University, Nanning 530022, China
| | - Qi-Liu Peng
- Central Laboratory of Medical Science, The Fifth Affiliated Hospital of Guangxi Medical University, Nanning 530022, China
| | - Dong-Hua Zou
- Department of Neurology, The Fifth Affiliated Hospital of Guangxi Medical University, Nanning 530022, China
| | - Rong-He Gu
- Department of Orthopedic Surgery, The Fifth Affiliated Hospital of Guangxi Medical University, Nanning 530022, China
| | - Fang-Tian Xu
- Department of Orthopedics, The First Affiliated Hospital of Gannan Medical University, Ganzhou 341000, China
| | - Hui Gao
- Department of Orthopedics, The First Affiliated Hospital of Gannan Medical University, Ganzhou 341000, China
| | - Zhen-Dong Chen
- Department of Orthopedics, The First Affiliated Hospital of Gannan Medical University, Ganzhou 341000, China
| | - Guang-Yi Chi
- Department of Plastic and Aesthetic Surgery, The Fifth Affiliated Hospital of Guangxi Medical University, Nanning 530022, China
| | - Zhong-Heng Wei
- Department of Glands Surgery, The Affiliated Hospital of Youjiang Medical University for Nationalities, Baise 533000, China
| | - Li Chen
- Department of Neurology, The First Affiliated Hospital of Guangxi Medical University, Nanning 530021, China
| | - Hong-Mian Li
- Department of Plastic and Aesthetic Surgery, The Fifth Affiliated Hospital of Guangxi Medical University, Nanning 530022, China
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Alperstein S, Dilcher T, Viswanathan K, Rao RA, Siddiqui MT, Giorgadze T. Acquired myospherulosis secondary to gluteal augmentation on fine needle aspiration cytology: A diagnostic challenge. Diagn Cytopathol 2017; 46:438-442. [PMID: 29239140 DOI: 10.1002/dc.23871] [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: 10/25/2017] [Accepted: 11/28/2017] [Indexed: 11/07/2022]
Abstract
A 30-year-old female presented with a three-month history of a multilocular cystic lesion over the lumbosacral spine. Fine-needle aspiration biopsy (FNA) of the lesion was performed at an outside institution, and a cytologic diagnosis, suspicious for chordoma, was rendered. The patient presented for surgical consultation at our institution. Repeat FNA demonstrated an unusual fat-like material. Upon further inquiry, the patient provided a recent history of gluteal contour improvement with fibroadipose tissue implants. A diagnosis of myospherulosis was made with a concurrent surgical pathology correlation. No evidence of chordoma was identified. To date, this is the first reported case of acquired myospherulosis in the context of gluteal contour enhancement and represents an important diagnostic pitfall to consider on cytology preparations.
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Affiliation(s)
- Susan Alperstein
- Papanicolau Cytology Laboratory, Department of Pathology and Laboratory Medicine, Weill Cornell Medical College, New York, New York
| | - Thomas Dilcher
- Papanicolau Cytology Laboratory, Department of Pathology and Laboratory Medicine, Weill Cornell Medical College, New York, New York
| | - Kartik Viswanathan
- Papanicolau Cytology Laboratory, Department of Pathology and Laboratory Medicine, Weill Cornell Medical College, New York, New York
| | - Rema A Rao
- Papanicolau Cytology Laboratory, Department of Pathology and Laboratory Medicine, Weill Cornell Medical College, New York, New York
| | - Momin T Siddiqui
- Papanicolau Cytology Laboratory, Department of Pathology and Laboratory Medicine, Weill Cornell Medical College, New York, New York
| | - Tamara Giorgadze
- Department of Pathology, Medical College of Wisconsin, Milwaukee, Wisconsin
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Merle R, Serror K, Marco O, Chaouat M, Teissier S, Mimoun M, Boccara D. [Study of satisfaction concerning the navel after abdominal dermolipectomy with transposition: A report of 96 cases]. ANN CHIR PLAST ESTH 2017; 63:215-221. [PMID: 29097008 DOI: 10.1016/j.anplas.2017.09.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2017] [Accepted: 09/28/2017] [Indexed: 11/16/2022]
Abstract
GOAL OF THE STUDY The umbilicus has a major role in the aesthetics of the anterior abdominal wall. Many publications deal with abdominal dermolipectomies but few focus on umbilicoplasty. However, these are essential in assessing the aesthetic result. Umbilicoplasty in "aile de mouette" used in our service is reliable and easily reproducible. In this article, we evaluate the satisfaction of patients with abdominal dermolipectomy with this technique of transposition. MATERIALS AND METHOD In the plastic surgery department of the Saint-Louis Hospital in Paris, we carried out a retrospective study of patients undergoing abdominal dermolipectomy with transposition of the umbilicus, between 1 January 2012 and 31 December 2012. All patients were operated according to our technique of umbilicoplasty: disinsertion of the umbilicus in V, reinsertion of the umbilic in "aile de mouette", a degreasing periumbilical associated with a plication of the umbilical stem. The complications identified in patients medical records and satisfaction were assessed by a telephone questionnaire. RESULTS Ninety-six patients were included. No patient presented umbilical necrosis. The overall result of umbilical transposition was considered good to excellent for 92.7% of patients. CONCLUSION Umbilicoplasty in gull wing has many advantages: it is a simple, easily reproducible, reliable technique, the patients of which are for the most part very satisfied.
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Affiliation(s)
- R Merle
- Service de chirurgie plastique, reconstructrice et esthétique, chirurgie de la main, CHU de Nice, 30, voie Romaine, 06001 Nice, France.
| | - K Serror
- Service de chirurgie plastique, reconstructrice et esthétique, centre de traitement des brulés, AP-HP St Louis, 1, avenue Claude-Vellefaux, 75010 Paris, France
| | - O Marco
- Service de chirurgie plastique, reconstructrice et esthétique, centre de traitement des brulés, AP-HP St Louis, 1, avenue Claude-Vellefaux, 75010 Paris, France
| | - M Chaouat
- Service de chirurgie plastique, reconstructrice et esthétique, centre de traitement des brulés, AP-HP St Louis, 1, avenue Claude-Vellefaux, 75010 Paris, France
| | - S Teissier
- Service de chirurgie plastique, reconstructrice et esthétique, chirurgie de la main, CHU de Nice, 30, voie Romaine, 06001 Nice, France
| | - M Mimoun
- Service de chirurgie plastique, reconstructrice et esthétique, centre de traitement des brulés, AP-HP St Louis, 1, avenue Claude-Vellefaux, 75010 Paris, France
| | - D Boccara
- Service de chirurgie plastique, reconstructrice et esthétique, centre de traitement des brulés, AP-HP St Louis, 1, avenue Claude-Vellefaux, 75010 Paris, France
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Levan P, Bassilios Habre S. Gluteal Implants Versus Autologous Flaps in Patients with Postbariatric Surgery Weight Loss: A Prospective Comparative Study of 3-Dimensional Gluteal Projection After Lower Body Lift. Aesthet Surg J 2017; 37:1012-1021. [PMID: 28398515 DOI: 10.1093/asj/sjx033] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Deformities and excess skin resulting from massive weight loss are corrected with circumferential lower body lift (LBL). The gluteal area is frequently flattened due to aggressive skin excision during LBL. Gluteal implants can circumvent this problem. OBJECTIVES We aimed to objectively evaluate the outcomes of gluteal augmentation with implants versus flap surgery performed simultaneously with LBL. METHODS Between January 2014 and June 2015, twenty-seven patients underwent LBL with gluteal implants (10 patients), flaps (14 patients), or no gluteal augmentation (3 patients) in our hospital. Three-dimensional analysis was used to assess gluteal projection preoperatively and at 6 months. Gain in projection, pain scores, complications, and patient and surgeon satisfaction were compared. RESULTS The mean follow-up duration was 18 months. The mean gain in projection at 6 months was 4.9 mm in the implant group, -0.5 mm in the flap group (P = 0.1), and -9.6 mm in the control group. The mean implant volume was 294.5 mL. Operation time was shorter in the flap group (192 min) than in the implant group (218 min, P = 0.001). Surgeon satisfaction was higher in the implant group (P = 0.007). Implants were more painful than flaps at 4 days and 2 weeks (P = 0.004 for both). There were 6 minor complications (60%) in the implant group versus 7 (50%) in the flap group (P = 0.94). CONCLUSIONS In selected patients, LBL with gluteal implants is safe and slightly increases gluteal projection. LEVEL OF EVIDENCE 2.
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Affiliation(s)
- Philippe Levan
- From the Department of Plastic and Reconstructive Surgery, Groupe Hospitalier Paris Saint-Joseph, Paris, France
| | - Samer Bassilios Habre
- From the Department of Plastic and Reconstructive Surgery, Groupe Hospitalier Paris Saint-Joseph, Paris, France
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11
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The Lipo-Body Lift: A New Circumferential Body-Contouring Technique Useful after Bariatric Surgery. Plast Reconstr Surg 2017; 139:38e-49e. [PMID: 28027231 DOI: 10.1097/prs.0000000000002926] [Citation(s) in RCA: 45] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
BACKGROUND After bariatric surgery, lifting of the lower body involves a contouring technique used to achieve optimal lower trunk reconstruction. The authors describe an innovative procedure applicable after massive weight loss: the lipo-body lift method. The authors describe their experience with this novel, safe procedure. METHODS Twenty-five abdominal body-contouring reconstructions following massive weight loss were treated by means of circumferential lipo-body lift. The authors describe the indications for the procedure and their perioperative and postoperative management. RESULTS The mean patient age was 39.4 years. The mean pre-body lift body mass index was 26.71 kg/m; the average weight loss before surgery was 56.6 kg, with a mean delta body mass index loss of 20.82 kg/m. The average hospital stay was 3.52 days and the drainage duration 3.56 days. No patient experienced any major complication (e.g., hematoma, thromboembolism, bleeding, skin necrosis, or a need for revision surgery to treat complications). Minor complications including wound dehiscence, wound infection, and fat necrosis were reported in 40 percent of patients. The occurrence of complications was associated with smoking status (p = 0.0280), the volume of liposuction (p = 0.0399), and the liposuction volume per unit of body mass index (p = 0.0071). CONCLUSIONS The authors' novel technique is less invasive than the traditional lower body-lifting method, as shown by the absence of major complications, and allows excellent conservation of connective tissue and vessels; undermining is minimal. As obesity becomes a major problem worldwide, lifting procedures that are safe and effective are important components of reconstructive strategies and should be widely offered to patients who experience massive weight loss. CLINICAL QUESTION/LEVEL OF EVIDENCE Therapeutic, IV.
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12
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Oranges CM, Tremp M, di Summa PG, Haug M, Kalbermatten DF, Harder Y, Schaefer DJ. Gluteal Augmentation Techniques: A Comprehensive Literature Review. Aesthet Surg J 2017; 37:560-569. [PMID: 28203698 DOI: 10.1093/asj/sjw240] [Citation(s) in RCA: 62] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Background Many studies of gluteal augmentation techniques have been published in recent decades, including case reports, retrospective and prospective case series, and multicenter survey reviews. However, to date, there has been no study of the overall complications or satisfaction rates associated with the broad spectrum of techniques. Objectives The authors performed a comprehensive literature review to determine outcomes and complications of gluteoplasty techniques, including patient satisfaction. Methods A search on PubMed/Medline was performed for clinical studies involving gluteal augmentation techniques. A priori criteria were used to review the resulting articles. Results Fifty-two studies, published from 1969 through 2015, were included - representing 7834 treated patients. Five gluteal augmentation techniques were identified from these studies: gluteal augmentation with implants (n = 4781), autologous fat grafting (n = 2609), local flaps (n = 369), hyaluronic acid gel injection (n = 69), and local tissue rearrangement (n = 6). The overall complication rates of the most commonly utilized techniques were: 30.5% for gluteal augmentation with implants, 10.5% for autologous fat grafting, and 22% for local flaps. Patients' satisfaction was reported as consistently high for all the five techniques. Conclusions Implant-based gluteal augmentation is associated with high patients' satisfaction despite a high complication rate, while autologous fat grafting is associated with the lowest complication rate yet including serious major complications such as fat embolism. Local flaps and local tissue rearrangements are the ideal procedures in case of massive weight loss patients. A paucity of data is available for hyaluronic acid gel injections, which appear to be effective but temporary and expensive. Level of Evidence 4
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Affiliation(s)
- Carlo M Oranges
- Department of Plastic, Reconstructive, Aesthetic, and Hand Surgery, Basel University Hospital, Basel, Switzerland
| | - Mathias Tremp
- Department of Plastic, Reconstructive, Aesthetic, and Hand Surgery, Basel University Hospital, Basel, Switzerland
| | - Pietro G di Summa
- Department of Plastic, Reconstructive, Aesthetic, and Hand Surgery, Basel University Hospital, Basel, Switzerland
| | - Martin Haug
- Department of Plastic, Reconstructive, Aesthetic, and Hand Surgery, Basel University Hospital, Basel, Switzerland
| | - Daniel F Kalbermatten
- Department of Plastic, Reconstructive, Aesthetic, and Hand Surgery, Basel University Hospital, Basel, Switzerland
| | - Yves Harder
- Division of Plastic, Reconstructive and Aesthetic Surgery, Ospedale Regionale di Lugano (ORL), Breast Centre of Switzerland (CSSI), Ente Ospedaliero Cantonale (EOC), Lugano, Switzerland
| | - Dirk J Schaefer
- Department of Plastic, Reconstructive, Aesthetic, and Hand Surgery, Basel University Hospital, Basel, Switzerland
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13
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Carloni R, Naudet F, Chaput B, de Runz A, Herlin C, Girard P, Watier E, Bertheuil N. Are There Factors Predictive of Postoperative Complications in Circumferential Contouring of the Lower Trunk? A Meta-Analysis. Aesthet Surg J 2016; 36:1143-1154. [PMID: 27402788 DOI: 10.1093/asj/sjw117] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/03/2016] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND The massive weight loss patient may require a circumferential contouring of the lower trunk. OBJECTIVES To summarize the complication rates and explore the possibility of predictive risk factors for complications. METHODS We performed a systematic review using the PubMed and Cochrane databases to identify published articles on the topic. Random effects meta-analyses and meta-regression were conducted to synthesize the data gathered. RESULTS The analysis included 28 studies and 1380 patients. All but one were retrospective cohorts or case studies. Circumferential contouring of the lower trunk resulted in 37% [95%-CI 30%; 44%] overall complications; 17% [95%-CI 12%; 24%] wound dehiscences; 4% [95%-CI 3%; 5%] skin necrosis; 5% [95%-CI 3%; 9%] infections; 3% [95%-CI 2%; 4%] hematomas; 13% [95%-CI 9%; 18%] seromas; 12% [95%-CI 7%; 21%] scar irregularities; 3% [95%-CI 2%; 5%] thromboembolism; and 5% [95%-CI 3%; 8%] revisions for complications. Lower body lift-related techniques were associated with a higher rate of overall complications than belt lipectomy-related techniques (P = .002). No difference in complication rate was shown when performing a gluteal augmentation with flap. Due to insufficient data reported in the studies, risk factors for postoperative complications could not be assessed. CONCLUSIONS The whole literature provides very low reliable information. Confusion factors could not be ruled out to explain the increased complications rate for the lower body lift compared to the belt lipectomy. This finding needs to be confirmed in randomized trials. Collaborative efforts must be made to improve the evidence level of our practices and to serve patients in an optimal way. LEVEL OF EVIDENCE 3 Therapeutic.
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Affiliation(s)
- Raphael Carloni
- Drs Carloni, Watier, and Bertheuil are Plastic and Reconstructive Surgeons, and Dr Girard is a Fellow, Department of Plastic, Reconstructive, and Aesthetic Surgery, Hospital Sud, University of Rennes, Rennes, France. Dr Naudet is a Psychiatrist and Methodologist, Department of Psychiatry, Centre Hospitalier Guillaume Régnier, Rennes, France. Dr Chaput is a Plastic and Reconstructive Surgeon, Department of Plastic, Reconstructive, and Aesthetic Surgery, Rangueil Hospital, Paul Sabatier University, Toulouse, France. Dr de Runz is a Plastic and Reconstructive Surgeon, Department of Maxillofacial, Plastic, Reconstructive, and Cosmetic Surgery, Nancy University Hospital, Nancy, France. Dr Herlin is a Plastic and Reconstructive Surgeon, Department of Plastic Surgery and Burn Surgery, Hospital Lapeyronie, Montpellier University Hospital, Montpellier, France
| | - Florian Naudet
- Drs Carloni, Watier, and Bertheuil are Plastic and Reconstructive Surgeons, and Dr Girard is a Fellow, Department of Plastic, Reconstructive, and Aesthetic Surgery, Hospital Sud, University of Rennes, Rennes, France. Dr Naudet is a Psychiatrist and Methodologist, Department of Psychiatry, Centre Hospitalier Guillaume Régnier, Rennes, France. Dr Chaput is a Plastic and Reconstructive Surgeon, Department of Plastic, Reconstructive, and Aesthetic Surgery, Rangueil Hospital, Paul Sabatier University, Toulouse, France. Dr de Runz is a Plastic and Reconstructive Surgeon, Department of Maxillofacial, Plastic, Reconstructive, and Cosmetic Surgery, Nancy University Hospital, Nancy, France. Dr Herlin is a Plastic and Reconstructive Surgeon, Department of Plastic Surgery and Burn Surgery, Hospital Lapeyronie, Montpellier University Hospital, Montpellier, France
| | - Benoit Chaput
- Drs Carloni, Watier, and Bertheuil are Plastic and Reconstructive Surgeons, and Dr Girard is a Fellow, Department of Plastic, Reconstructive, and Aesthetic Surgery, Hospital Sud, University of Rennes, Rennes, France. Dr Naudet is a Psychiatrist and Methodologist, Department of Psychiatry, Centre Hospitalier Guillaume Régnier, Rennes, France. Dr Chaput is a Plastic and Reconstructive Surgeon, Department of Plastic, Reconstructive, and Aesthetic Surgery, Rangueil Hospital, Paul Sabatier University, Toulouse, France. Dr de Runz is a Plastic and Reconstructive Surgeon, Department of Maxillofacial, Plastic, Reconstructive, and Cosmetic Surgery, Nancy University Hospital, Nancy, France. Dr Herlin is a Plastic and Reconstructive Surgeon, Department of Plastic Surgery and Burn Surgery, Hospital Lapeyronie, Montpellier University Hospital, Montpellier, France
| | - Antoine de Runz
- Drs Carloni, Watier, and Bertheuil are Plastic and Reconstructive Surgeons, and Dr Girard is a Fellow, Department of Plastic, Reconstructive, and Aesthetic Surgery, Hospital Sud, University of Rennes, Rennes, France. Dr Naudet is a Psychiatrist and Methodologist, Department of Psychiatry, Centre Hospitalier Guillaume Régnier, Rennes, France. Dr Chaput is a Plastic and Reconstructive Surgeon, Department of Plastic, Reconstructive, and Aesthetic Surgery, Rangueil Hospital, Paul Sabatier University, Toulouse, France. Dr de Runz is a Plastic and Reconstructive Surgeon, Department of Maxillofacial, Plastic, Reconstructive, and Cosmetic Surgery, Nancy University Hospital, Nancy, France. Dr Herlin is a Plastic and Reconstructive Surgeon, Department of Plastic Surgery and Burn Surgery, Hospital Lapeyronie, Montpellier University Hospital, Montpellier, France
| | - Christian Herlin
- Drs Carloni, Watier, and Bertheuil are Plastic and Reconstructive Surgeons, and Dr Girard is a Fellow, Department of Plastic, Reconstructive, and Aesthetic Surgery, Hospital Sud, University of Rennes, Rennes, France. Dr Naudet is a Psychiatrist and Methodologist, Department of Psychiatry, Centre Hospitalier Guillaume Régnier, Rennes, France. Dr Chaput is a Plastic and Reconstructive Surgeon, Department of Plastic, Reconstructive, and Aesthetic Surgery, Rangueil Hospital, Paul Sabatier University, Toulouse, France. Dr de Runz is a Plastic and Reconstructive Surgeon, Department of Maxillofacial, Plastic, Reconstructive, and Cosmetic Surgery, Nancy University Hospital, Nancy, France. Dr Herlin is a Plastic and Reconstructive Surgeon, Department of Plastic Surgery and Burn Surgery, Hospital Lapeyronie, Montpellier University Hospital, Montpellier, France
| | - Paul Girard
- Drs Carloni, Watier, and Bertheuil are Plastic and Reconstructive Surgeons, and Dr Girard is a Fellow, Department of Plastic, Reconstructive, and Aesthetic Surgery, Hospital Sud, University of Rennes, Rennes, France. Dr Naudet is a Psychiatrist and Methodologist, Department of Psychiatry, Centre Hospitalier Guillaume Régnier, Rennes, France. Dr Chaput is a Plastic and Reconstructive Surgeon, Department of Plastic, Reconstructive, and Aesthetic Surgery, Rangueil Hospital, Paul Sabatier University, Toulouse, France. Dr de Runz is a Plastic and Reconstructive Surgeon, Department of Maxillofacial, Plastic, Reconstructive, and Cosmetic Surgery, Nancy University Hospital, Nancy, France. Dr Herlin is a Plastic and Reconstructive Surgeon, Department of Plastic Surgery and Burn Surgery, Hospital Lapeyronie, Montpellier University Hospital, Montpellier, France
| | - Eric Watier
- Drs Carloni, Watier, and Bertheuil are Plastic and Reconstructive Surgeons, and Dr Girard is a Fellow, Department of Plastic, Reconstructive, and Aesthetic Surgery, Hospital Sud, University of Rennes, Rennes, France. Dr Naudet is a Psychiatrist and Methodologist, Department of Psychiatry, Centre Hospitalier Guillaume Régnier, Rennes, France. Dr Chaput is a Plastic and Reconstructive Surgeon, Department of Plastic, Reconstructive, and Aesthetic Surgery, Rangueil Hospital, Paul Sabatier University, Toulouse, France. Dr de Runz is a Plastic and Reconstructive Surgeon, Department of Maxillofacial, Plastic, Reconstructive, and Cosmetic Surgery, Nancy University Hospital, Nancy, France. Dr Herlin is a Plastic and Reconstructive Surgeon, Department of Plastic Surgery and Burn Surgery, Hospital Lapeyronie, Montpellier University Hospital, Montpellier, France
| | - Nicolas Bertheuil
- Drs Carloni, Watier, and Bertheuil are Plastic and Reconstructive Surgeons, and Dr Girard is a Fellow, Department of Plastic, Reconstructive, and Aesthetic Surgery, Hospital Sud, University of Rennes, Rennes, France. Dr Naudet is a Psychiatrist and Methodologist, Department of Psychiatry, Centre Hospitalier Guillaume Régnier, Rennes, France. Dr Chaput is a Plastic and Reconstructive Surgeon, Department of Plastic, Reconstructive, and Aesthetic Surgery, Rangueil Hospital, Paul Sabatier University, Toulouse, France. Dr de Runz is a Plastic and Reconstructive Surgeon, Department of Maxillofacial, Plastic, Reconstructive, and Cosmetic Surgery, Nancy University Hospital, Nancy, France. Dr Herlin is a Plastic and Reconstructive Surgeon, Department of Plastic Surgery and Burn Surgery, Hospital Lapeyronie, Montpellier University Hospital, Montpellier, France
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Cosmetic Body Lift. Plast Reconstr Surg 2016; 138:945e-946e. [PMID: 27391822 DOI: 10.1097/prs.0000000000002725] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Circumferential Contouring of the Lower Trunk: Indications, Operative Techniques, and Outcomes-A Systematic Review. Aesthetic Plast Surg 2016; 40:652-68. [PMID: 27286851 DOI: 10.1007/s00266-016-0660-7] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2016] [Accepted: 05/25/2016] [Indexed: 12/11/2022]
Abstract
BACKGROUND Increasing obesity prevalence and development of bariatric surgery have led to the development of skin re-draping techniques. Several contouring techniques have been described for treating the circumferential excess of the lower trunk. MATERIALS AND METHODS We performed a systematic review to summarize surgical indications, operative techniques, peri-operative management (nutritional supplementation, antibiotic prophylaxis, thrombo-prophylaxis), outcomes, complications, patient satisfaction, and impact on quality of life of circumferential contouring of the lower trunk procedures. A systematic review, based on the PRISMA criteria, was conducted using the Pubmed and Cochrane databases. RESULTS The review included 42 articles and 1748 operated patients. Two studies only were graded as level of evidence II; the others were graded as levels III to V. The most frequently reported indication was massive weight loss. All the described techniques derived either from belt lipectomy or lower bodylift. Belt lipectomy resulted in a posterior scar situated at the waistline and allowed a better correction of hip back rolls, whereas lower bodylift was more effective on buttock and lateral thigh ptosis. The most reported complication was wound dehiscence. Patient satisfaction and quality of life scores were high in all studies. CONCLUSIONS This review included a majority of low-level evidence studies that limit extrapolability of the results. Future randomized prospective studies may generate stronger evidence, with a standardization of surgical indications and operative techniques. LEVEL OF EVIDENCE III This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .
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Ellart J, Grolleau JL, Gangloff D, Meresse T, Garrido I, Bertheuil N, Carloni R, Chaput B. [Morbidity of bodylift. Evaluation of 111 patients over 5 years]. ANN CHIR PLAST ESTH 2016; 61:820-826. [PMID: 27666182 DOI: 10.1016/j.anplas.2016.08.006] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2016] [Accepted: 08/23/2016] [Indexed: 12/11/2022]
Abstract
INTRODUCTION The management of patients with weight loss sequelae, sometimes major, is increasingly well standardized. However, this surgery is not without risk. Complications of bodylift are more frequent than those of conventional abdominoplasties. The objective of this study was to evaluate the morbidity associated with this surgery through a retrospective, single-center study. MATERIALS AND METHODS One hundred and eleven circular abdominaloplasties were conducted between June 2011 and September 2015 in the plastic surgery department of the university hospital of Toulouse. Minor and major complications were identified and analyzed. RESULTS Frequency of postoperative complications was 44.1% in our series. Major complications have involved 15.3% of patients. Blood transfusions (9%) and hematoma requiring reoperation (7.2%) were the most frequent major complications. We found significantly more major complications in patients with important fat resection with a cut off at 3200 g (P=0.02). Men experienced significantly more major complications than women (P=0.005). The average delta-BMI (before and after weight loss) was significantly higher in the group of patients with the highest percentage of minor complications (P=0.045). Indeed, a high delta-BMI (greater than 19.5) was associated with an excess risk of minor complications in our population. CONCLUSION Democratization and progress in the field of bodylift should not obscure the fact that it is, in reality, a procedure at risk. While we manage increasingly better cosmetic results and thromboembolic complications, it still persists many complications.
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Affiliation(s)
- J Ellart
- Service de chirurgie plastique, reconstructrice et esthétique, centre hospitalier universitaire de Lille, rue Émile-Laine, 59037 Lille, France
| | - J-L Grolleau
- Service de chirurgie plastique, reconstructrice et esthétique, centre hospitalier universitaire de Toulouse, 1, avenue Jean-Poulhès, 31059 Toulouse, France
| | - D Gangloff
- Service de chirurgie plastique, reconstructrice et esthétique, centre hospitalier universitaire de Toulouse, 1, avenue Jean-Poulhès, 31059 Toulouse, France
| | - T Meresse
- Service de chirurgie plastique, reconstructrice et esthétique, centre hospitalier universitaire de Toulouse, 1, avenue Jean-Poulhès, 31059 Toulouse, France
| | - I Garrido
- Service de chirurgie plastique, reconstructrice et esthétique, centre hospitalier universitaire de Toulouse, 1, avenue Jean-Poulhès, 31059 Toulouse, France
| | - N Bertheuil
- Service de chirurgie plastique, reconstructrice et esthétique, hôpital Sud, université de Rennes 1, 2, rue Henri-Le-Guillax, 35000 Rennes, France
| | - R Carloni
- Service de chirurgie plastique, reconstructrice et esthétique, centre hospitalier universitaire Charles-Nicolle, 1, rue de Germont, 76031 Rouen cedex, France
| | - B Chaput
- Service de chirurgie plastique, reconstructrice et esthétique, centre hospitalier universitaire de Toulouse, 1, avenue Jean-Poulhès, 31059 Toulouse, France.
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[Lower bodylift after massive weight loss: Retrospective study of satisfaction, complications and quality of life. About 76 patients over 4years]. ANN CHIR PLAST ESTH 2016; 61:827-835. [PMID: 27473934 DOI: 10.1016/j.anplas.2016.06.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2016] [Accepted: 06/08/2016] [Indexed: 12/28/2022]
Abstract
INTRODUCTION Massive weight loss leads to important cutaneous deformities with physical and psychological repercussions for patients. Lower bodylift is a procedure, which can restore the body contour. The aim of this study is to evaluate satisfaction and quality of life in patients who underwent lower bodylift and to review the complications of these procedures. MEANS AND METHODS This is a retrospective study of 76 patients who underwent lower bodylift between 2012 and 2016. We reviewed the complications of these procedures. Satisfaction and quality of life were assessed using Body-QoL questionnaire. RESULTS Seventy-six patients were included with a mean age of 39.2years. The average body mass index was 27.6kg/m2 with a mean weight of 71.2kg at the time of surgery and a mean weight loss of 48.6kg. Twenty-three patients developed one complication: 22 minor and 1 major. Forty-eight patients answered the questionnaire. Satisfaction was rated "very good" by 41 patients (85.4%) and "good" by 5 patients (10.4%). The Body-QoL questionnaire's analysis showed an improvement of quality of life socially, sexually, in the body regard and in physical symptoms. CONCLUSIONS Lower bodylift is the only procedure, which can restore circumferential body contour. Despite the minor complications reviewed, the degree of satisfaction of the patients is very high. The quality of life of these patients, after massive weight loss, is also highly improved by these procedures. With the worldwide development of obesity and bariatric surgery, this study demonstrated that the operation should be proposed to patients with massive weight loss to improve quality of life.
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