Summary
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.
Key words
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Article info
Publication history
Published online: December 15, 2018
Accepted:
December 2,
2018
Received in revised form:
October 28,
2018
Received:
June 29,
2018
Identification
Copyright
© 2018 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.
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- Abdominoplasty in massive weight loss patient: Modifying the technique to improve the safetyJournal of Plastic, Reconstructive & Aesthetic SurgeryVol. 72Issue 6
- PreviewWe read with great interest the recent article by Pajula et al.1 regarding complications after lower body contouring in massive weight loss patients. This retrospective review analyzed 158 patients undergoing abdominoplasty or belt lipectomy after massive weight loss. Patients were divided into two groups using the weight loss method employed: those who lost weight through bariatric surgery (90 patients, 57%) and those who lost weight through diet or physical activity (68 patients, 43%). The most common bariatric procedure was gastric bypass (75 patients, 83.3%) followed by sleeve gastrectomy (14 patients, 15.5%), and gastric balloon (1 patient, 1.1%).
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