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Lippi L, Ferrillo M, Losco L, Folli A, Marcasciano M, Curci C, Moalli S, Ammendolia A, de Sire A, Invernizzi M. Aesthetic Rehabilitation Medicine: Enhancing Wellbeing beyond Functional Recovery. MEDICINA (KAUNAS, LITHUANIA) 2024; 60:603. [PMID: 38674249 PMCID: PMC11052208 DOI: 10.3390/medicina60040603] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/11/2024] [Revised: 04/02/2024] [Accepted: 04/04/2024] [Indexed: 04/28/2024]
Abstract
Although rehabilitation medicine emphasizes a holistic health approach, there is still a large gap of knowledge about potential interventions aimed at improving overall wellbeing through cosmetic interventions. Therefore, this narrative review investigates the role of different rehabilitative techniques in enhancing aesthetics, quality of life, and psychosocial wellbeing for patients with disabilities. The study follows the SANRA framework quality criteria for a narrative review. Literature searches across PubMed/Medline, Web of Science, and Scopus identified articles focusing on rehabilitation strategies within the aesthetic rehabilitation domain. The review identified evidence supporting injection procedures, such as Botulinum Toxin, Platelet-Rich Plasma, Hyaluronic Acid, Ozone, and Carboxytherapy, and assessing their applications in several disabling disorders. Additionally, physical therapies like Extracorporeal Shock Wave Therapy, Laser Therapy, Microcurrent Therapy, Tecar Therapy, and physical exercises were explored for their impact on cutaneous microcirculation, cellulite treatment, wound healing, and scar appearance improvement. Lastly, the manuscript underlines the role of manual therapy techniques in addressing both physical discomfort and aesthetic concerns, discussing their effectiveness in adipose tissue therapy, scar tissue mobilization, and regional fat thickness reduction. Taken together, this review emphasizes the role of a multidisciplinary approach, aiming to provide valuable insights into potential benefits for both functional and aesthetic outcomes.
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Affiliation(s)
- Lorenzo Lippi
- Department of Health Sciences, University of Eastern Piedmont “A. Avogadro”, 28100 Novara, Italy; (L.L.); (A.F.); (S.M.); (M.I.)
- Translational Medicine, Dipartimento Attività Integrate Ricerca e Innovazione (DAIRI), Azienda Ospedaliera SS. Antonio e Biagio e Cesare Arrigo, 15121 Alessandria, Italy
| | - Martina Ferrillo
- Department of Health Sciences, School of Dentistry, University of Catanzaro “Magna Graecia”, 88100 Catanzaro, Italy;
| | - Luigi Losco
- Plastic Surgery Unit, Department of Medicine, Surgery and Dentistry, University of Salerno, Via Salvador Allende, 43, 84081 Baronissi, Italy;
| | - Arianna Folli
- Department of Health Sciences, University of Eastern Piedmont “A. Avogadro”, 28100 Novara, Italy; (L.L.); (A.F.); (S.M.); (M.I.)
| | - Marco Marcasciano
- Plastic Surgery, Experimental and Clinical Medicine Department, Division of Plastic and Reconstructive Surgery, “Magna Graecia” University of Catanzaro, 88100 Catanzaro, Italy;
| | - Claudio Curci
- Physical Medicine and Rehabilitation Unit, Department of Neurosciences, ASST Carlo Poma, 46100 Mantova, Italy
| | - Stefano Moalli
- Department of Health Sciences, University of Eastern Piedmont “A. Avogadro”, 28100 Novara, Italy; (L.L.); (A.F.); (S.M.); (M.I.)
| | - Antonio Ammendolia
- Physical and Rehabilitative Medicine, Department of Medical and Surgical Sciences, University of Catanzaro “Magna Graecia”, 88100 Catanzaro, Italy;
- Research Center on Musculoskeletal Health, MusculoSkeletalHealth@UMG, University of Catanzaro “Magna Graecia”, 88100 Catanzaro, Italy
| | - Alessandro de Sire
- Physical and Rehabilitative Medicine, Department of Medical and Surgical Sciences, University of Catanzaro “Magna Graecia”, 88100 Catanzaro, Italy;
- Research Center on Musculoskeletal Health, MusculoSkeletalHealth@UMG, University of Catanzaro “Magna Graecia”, 88100 Catanzaro, Italy
| | - Marco Invernizzi
- Department of Health Sciences, University of Eastern Piedmont “A. Avogadro”, 28100 Novara, Italy; (L.L.); (A.F.); (S.M.); (M.I.)
- Translational Medicine, Dipartimento Attività Integrate Ricerca e Innovazione (DAIRI), Azienda Ospedaliera SS. Antonio e Biagio e Cesare Arrigo, 15121 Alessandria, Italy
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Losco L, Roxo AC, Roxo CW, Alfano C, Roxo CDP. Comment on "The Three-Hour Lower Body Lift: Evolution of a Technique and Personal Experience After 155 Consecutive Cases" and Tips to Prevent Posterior Wound Dehiscence. Aesthetic Plast Surg 2023; 47:24-25. [PMID: 35304620 DOI: 10.1007/s00266-022-02855-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2022] [Accepted: 02/21/2022] [Indexed: 12/13/2022]
Affiliation(s)
- Luigi Losco
- Plastic Surgery Unit, Department of Medicine, Surgery and Dentistry, University of Salerno, Via Salvador Allende, 43, 84081, Baronissi, Salerno, Italy.
- Plastic Surgery Unit, Andaraì Federal Hospital, Rio de Janeiro, Brazil.
| | - Ana Claudia Roxo
- Plastic Surgery Unit, Pedro Ernesto University Hospital, Rio de Janeiro, Brazil
| | - Carlos Weck Roxo
- Plastic Surgery Unit, Andaraì Federal Hospital, Rio de Janeiro, Brazil
| | - Carmine Alfano
- Plastic Surgery Unit, Department of Medicine, Surgery and Dentistry, University of Salerno, Via Salvador Allende, 43, 84081, Baronissi, Salerno, Italy
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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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Giuglea C, Burlacu EC, Dumitrache S, Tene MG, Marin A, Jianu DM, Marinescu SA. Negative Pressure Wound Therapy in Postbariatric Lower Body Lift-A Method of Decreasing Postoperative Complications. Aesthetic Plast Surg 2022; 46:2882-2890. [PMID: 35641686 DOI: 10.1007/s00266-022-02911-w] [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: 02/04/2022] [Accepted: 04/19/2022] [Indexed: 12/13/2022]
Abstract
BACKGROUND Lower body lift procedure is one of the most common procedures in postbariatric surgery, which can be followed by postoperative complications that delay the healing time. The purpose of this study was to analyse whether the use of negative pressure wound therapy (NPWT) as a replacement for the classical drainage method would provide better postoperative results with fewer complications. METHODS The authors reviewed their experience with 46 consecutive patients that underwent lower body lift surgery from 2018 to 2021. They were divided into two groups: 23 of them received NPWT as drainage method and another 23 received classical active drains. We assessed the complication rates and types between the two groups to demonstrate the efficiency of NPWT as a support in the surgical protocol. RESULTS Forty-six patients were included in this study. Two equal groups formed by 23 patients were analysed for age, sex, type of weight loss, type of circumferential lower body lift, type of drainage, quantity of drainage, time of drain usance, postoperative complications, operation time, hospital stay and frequency of hospital visits. The group that received NPWT had a 26.08% rate of complications as compared with the drain group that had a 47.8% complication rate. CONCLUSIONS This study is performed as a comparison between negative pressure wound therapy and classical drainage method in lower body lift surgery, as a new method of reducing the postoperative complications. By achieving faster closure of large, undermining areas, it concludes in a lower risk of seroma or hematoma formation. 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 the Table of Contents or the online Instructions to Authors www.springer.com/00266 .
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Affiliation(s)
- Carmen Giuglea
- Clinical Emergency Hospital Sf. Ioan, Bucharest, Romania
| | | | - Serban Dumitrache
- Clinical Emergency Hospital Sf. Ioan, Bucharest, Romania.,Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
| | | | - Andrei Marin
- Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
| | - Dana Mihaela Jianu
- ProEstetica Medical, International Society for Regenerative Medicine & Surgery, Bucharest, Romania
| | - Silviu-Adrian Marinescu
- Carol Davila University of Medicine and Pharmacy, Bucharest, Romania.,Clinical Emergency Hospital Bagdasar-Arseni, Bucharest, Romania
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Saheb-Al-Zamani M. Mons Pubis Lift (Monsplasty). Clin Plast Surg 2022; 49:479-487. [DOI: 10.1016/j.cps.2022.06.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Cinclair R, Shang Z, Aly A, Kenkel J. The Impact of Comorbidities on Patient Outcomes in the Upper Body Lift: A Retrospective Review. Aesthet Surg J Open Forum 2022; 4:ojac063. [PMID: 36128596 PMCID: PMC9475277 DOI: 10.1093/asjof/ojac063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Background Nonsurgical and surgical weight loss options have improved over the past several decades resulting in an increased number of patients who present with body contour deformities. This review focuses on the upper truncal deformity. This deformity is discernable by its residual tissue laxity in the upper arm, back, lateral chest, and breast. Objective The purpose of this study is to evaluate the morbidity of this procedure when these regions are treated in one operative setting. Methods A retrospective chart review of patients who underwent an upper body lift for truncal deformities after massive weight loss by the senior author between August 2006 and December 2019 was performed. Patient comorbidities and demographics, preoperative parameters, operative factors, and minor and major complications were assessed. Results No intraoperative or major complications occurred. The overall complication rate was 71% (20/28), which were all minor and most related to wound breakdown. Using logistical regression analysis, we found that neither BMI nor amount of weight resected contributed to a higher complication rate in this cohort. Simple matching coefficients analysis identified anemia, hypertension, lifetime smoking history, celecoxib use, and multiple concurrent procedures as comorbidities and intraoperative factors with an increased risk for adverse outcomes. Conclusions This review helps define the role of upper body lift in the care of patients with massive weight loss and addresses the morbidity of a comprehensive approach to upper body deformity. Appropriate patient selection, preoperative patient counseling, sound operative technique, and supportive postoperative care can help to avoid adverse outcomes. Level of Evidence 4
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Affiliation(s)
- Richard Cinclair
- Corresponding Author: Mr Richard Cinclair III, Department of Plastic Surgery, University of Texas Southwestern, 1801 Inwood Road 5th Floor, Dallas, TX 75390, USA. E-mail: ; Instagram: @treycinclair
| | - Zhiguo Shang
- Department of Bioinformatics, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Al Aly
- Department of Plastic Surgery, University of Texas Southwestern Medical Center, Dallas, TX, USA; and a body contouring section editor for Aesthetic Surgery Journal
| | - Jeffrey Kenkel
- Department of Plastic Surgery, University of Texas Southwestern Medical Center, Dallas, TX, USA; editor-in-chief of ASJ Open Forum; and associate editor of Aesthetic Surgery Journal
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Zaussinger M, Wenny R, Schwartz B, Ehebruster G, Huemer GM, Schmidt M. De-epithelialized Dermal Flap to Reduce Sacral Wound Healing Complications After Lower Body Lift Procedure. Aesthet Surg J 2022; 42:NP451-NP460. [PMID: 35079779 DOI: 10.1093/asj/sjac012] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND Lower or circumferential body lift procedures in the massive-weight-loss population have been associated with significant complication rates. Particularly, the sacral area is at risk of wound-healing problems due to high wound tension or shear forces. OBJECTIVES The authors introduced a de-epithelialized dermal flap to reinforce the sacral area. METHODS Within this retrospective study, outcomes of 40 consecutive patients who underwent lower body lift between 2017 and 2021 were analyzed. The patient population was divided into 2 study groups (sacral flap vs no flap) including 20 patients each. Demographic and surgical data as well as complications were evaluated and compared. Appropriate statistical analysis was performed. RESULTS Thirty-seven female and 3 male patients with a median age of 36.5 years (range, 23-54 years) and a mean weight loss of 46.3 ± 12 kg participated in the study. The most common complication was sacral wound dehiscence (n = 7, 17.5%), and its occurrence was statistically significantly lower in the sacral flap group (P = 0.037). The odd ratios for complications when executing the sacral flap procedure were reduced to 0.306 (95% confidence interval = 0.075 to 1.246) and 0.261 (95% confidence interval = 0.055 to 1.250) for the uncorrected and corrected logistic regressions, respectively. In addition, findings showed a significantly shorter hospital stay as well as statistical trends towards a lower occurrence of overall complications in the sacral flap group. Concerning the remaining data, no statistically significant differences between study groups were detected. CONCLUSIONS The presented de-epithelialized dermal flap leads to a significant reduction of sacral wound-healing complications and a shorter hospital stay for patients. This surgical technique is easily reproduceable, rapid, and effective; therefore, we would recommend it for each circumferential or lower body lift procedure. LEVEL OF EVIDENCE: 4
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Affiliation(s)
| | - Raphael Wenny
- Johannes Kepler University Linz Medical Faculty , Linz , Austria
| | - Bernhard Schwartz
- Department for Research and Development, University of Applied Sciences for Health Professions , Linz , Austria
| | | | - Georg M Huemer
- Johannes Kepler University Linz Medical Faculty , Linz , Austria
| | - Manfred Schmidt
- Johannes Kepler University Linz Medical Faculty , Linz , Austria
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Ibrahiem SMS. Investigating the Safety of Multiple Body Contouring Procedures in Massive Weight Loss Patients. Aesthetic Plast Surg 2022; 46:2891-2902. [PMID: 35650300 PMCID: PMC9729125 DOI: 10.1007/s00266-022-02941-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2022] [Accepted: 05/08/2022] [Indexed: 12/14/2022]
Abstract
INTRODUCTION Deformities after massive weight loss are usually severe and affect many parts of the body, negatively impacting patients' social and intimate lives. A common request of patients after massive weight loss is to treat more than one anatomical area in one surgical procedure. Advantages include a single recovery period, lower surgical costs, and faster patient satisfaction. Disadvantages may include increased need for blood transfusions, longer hospital stay, and increased risk of common complications. OBJECTIVE The main objective of the study is to compare operative risk, hospital length of stay, complication rate, and patient satisfaction in MWLP according to the number of surgical procedures performed in the same surgical setting. PATIENTS AND METHODS This is a retrospective case-control study of 653 MWLP who underwent multiple contouring procedures simultaneously in a single surgical procedure. All patients underwent surgery between 2016 and 2020. The patients studied were divided into 4 groups according to the number of anatomical areas operated on. RESULTS A total of 1254 body contouring procedures were included in the study. Follow-up time ranged from 13 to 41 months, with a mean of 17 months. The mean age in the study was 33 years old. Women accounted for 78% of the studied population and men accounted for 22%. The overall complication rate (major and minor) was 105 cases (16.07%) in all groups CONCLUSION: Patient satisfaction was highest in patients who underwent 2-3 procedures within the same surgical setting compared to patients who underwent +3 procedures. Nevertheless, this is clinically insignificant. LEVEL OF EVIDENCE IV This journal requires that authors assign a level of evidence to each submission to which Evidence-Based Medicine rankings are applicable. This excludes Review Articles, Book Reviews, and manuscripts that concern Basic Science, Animal Studies, Cadaver Studies, and Experimental Studies. 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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Affiliation(s)
- Saad Mohamed Saad Ibrahiem
- grid.7155.60000 0001 2260 6941Department of Plastic Surgery, Reconstructive Surgery, and Burn Management, Faculty of Medicine, Alexandria University, Champollion Street, El-Khartoum Square, Azarita Medical Campus, Alexandria, 21111 Egypt
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Ferry AM, Chamata E, Dibbs RP, Rappaport NH. Avoidance and Correction of Deformities in Body Contouring. Semin Plast Surg 2021; 35:110-118. [PMID: 34121946 DOI: 10.1055/s-0041-1727207] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
Body contouring procedures are highly impactful because of their potential to improve a patient's quality of life. These procedures, particularly when performed on patients following massive weight loss, may require secondary intervention to treat residual contour abnormalities. Presently, there is a paucity of information in the literature detailing the avoidance and correction of body contouring deformities. Herein, we will discuss the management of patients seeking revisional body contouring procedures.
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Affiliation(s)
- Andrew M Ferry
- Division of Plastic Surgery, Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, Texas
| | - Edward Chamata
- Division of Plastic Surgery, Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, Texas
| | - Rami P Dibbs
- Division of Plastic Surgery, Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, Texas
| | - Norman H Rappaport
- Division of Plastic Surgery, Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, Texas.,Houston Center for Plastic Surgery, Houston, Texas
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Losco L, Roxo AC, Roxo CW, Lo Torto F, Bolletta A, de Sire A, Aksoyler D, Ribuffo D, Cigna E, Roxo CP. Lower Body Lift After Bariatric Surgery: 323 Consecutive Cases Over 10-Year Experience. Aesthetic Plast Surg 2020; 44:421-432. [PMID: 31748908 DOI: 10.1007/s00266-019-01543-x] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2019] [Accepted: 11/02/2019] [Indexed: 12/12/2022]
Abstract
BACKGROUND Lower body lift is a widespread procedure for massive weight loss patients aimed to improve the contour of the lower trunk, gluteal region and proximal lower extremity. The data about complications are confusing, and there is a lack of uniform studies for massive weight loss patients. A simple formula to carry out a reliable procedure in a short time with a low complication rate should be advocated. METHODS This retrospective study analyzed data of 323 patients undergoing lower body lift after bariatric surgery over a 10-year period. Selection criteria, careful preoperative marking, reliable intra- and postoperative care and a few surgical tips are discussed. All the complications (both major and minor) and the aesthetic satisfaction were evaluated. Risk factors assessed were patient age, tobacco consumption, current BMI, operative time and combined surgery. RESULTS The overall complication rate was 42%. We recorded a lower rate of major complications and skin dehiscence; no infection and no skin necrosis were observed. The most frequent complication was seroma (35%). A complication development was straight related to age (p = 0.0177) and tobacco use (p = 0.0336). Patients' satisfaction about overall aesthetic was high. CONCLUSIONS We present our case load and describe an easy recipe to perform a safe surgery without undermining and liposuction in short operative times. The reasonable overall complication rate and the surprisingly lower rate of dehiscence and skin necrosis combined with a pleasant aesthetic result make the lower body lift an easy and safe procedure, when applied to the appropriate patient population. 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 the Table of Contents or the online Instructions to Authors www.springer.com/00266.
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Affiliation(s)
- Luigi Losco
- Plastic Surgery Unit, Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Via Roma 67, 56125, Pisa, Italy.
| | - Ana Claudia Roxo
- Plastic Surgery Unit, Pedro Ernesto University Hospital, Rio de Janeiro, Brazil
| | - Carlos W Roxo
- Plastic Surgery Unit, Andaraì Federal Hospital, Rio de Janeiro, Brazil
| | - Federico Lo Torto
- Plastic Surgery Unit, Department of Surgery, Sapienza University of Rome, Rome, Italy
| | - Alberto Bolletta
- Plastic Surgery Unit, Department of Medical, Surgical and Experimental Sciences, University of Sassari, Sassari, Italy
| | - Alessandro de Sire
- Physical and Rehabilitation Medicine, Department of Health Sciences, University of Eastern Piedmont, Novara, Italy
| | - Dicle Aksoyler
- Department of Plastic Reconstructive and Aesthetic Surgery, China Medical University Hospital, Taichung, Taiwan
| | - Diego Ribuffo
- Plastic Surgery Unit, Department of Surgery, Sapienza University of Rome, Rome, Italy
| | - Emanuele Cigna
- Plastic Surgery Unit, Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Via Roma 67, 56125, Pisa, Italy
| | - Carlos P Roxo
- Plastic Surgery Unit, Andaraì Federal Hospital, Rio de Janeiro, Brazil
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Complications after lower body contouring surgery due to massive weight loss unaffected by weight loss method. J Plast Reconstr Aesthet Surg 2018; 72:649-655. [PMID: 30616907 DOI: 10.1016/j.bjps.2018.12.030] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2018] [Revised: 10/28/2018] [Accepted: 12/02/2018] [Indexed: 01/08/2023]
Abstract
Body contouring surgery following massive weight loss positively affects a patient's quality of life. However, the procedure is prone to complications. Herein, we stratified complications timewise. Furthermore, we examined whether the weight loss method - bariatric surgery or lifestyle changes - affected the frequency or severity of complications. In this single-centre retrospective analysis, we included 158 patients with massive weight loss undergoing body contouring surgery between 2009 and 2015. We recorded 96 complications in 80 patients, with an overall rate of 51%. Most complications (80.2%) were minor (Clavien-Dindo grades 1 and 2) and superficial wound infections. Immediate complications (0-24 hours post-operation) affected 8.3% of patients, with early complications (1-7 post-operative days) affecting 16.7% of them and late complications (8-30 post-operative days) affecting 58.3% of them. We found no statistical difference in complication rates when comparing bariatric and non-bariatric patients. Older age (p = 0.042) at operation is associated with an increased risk for immediate haematoma or bleeding requiring surgery. Among early complications, a high maximum weight (p = 0.035) and a high preoperative weight (p = 0.0053) significantly correlated with a haematoma or bleeding requiring surgery. For late complications, seroma correlated with older age (p = 0.0061). Complications are primarily minor and non-life threatening after body contouring surgery because of frequent massive weight loss. Here, no particular subgroup of massive weight loss patients appeared more prone to complications. Thus, for each patient, the risks associated with body contouring surgery following massive weight loss should be considered individually.
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