Background:The epidemic of obesity in the United States has led to a rapid increase in the number of bariatric procedures performed over the past several years. The dramatic changes to the torso following massive weight loss are only partially addressed by routine procedures such as abdominoplasty and liposuction. Circumferential body lifts or simultaneous abdominoplasty, thigh, and buttock lifts are becoming the method of choice for treating the postbariatric condition. In this article, the authors review the senior author's experience of 200 body lifts with massive weight loss individuals. Methods: The charts of 200 consecutive body lift patients were reviewed for complications and other variables. The preoperative markings, current surgical technique, and postoperative care are described. The patients were classified into three types according to their body mass index at the time of surgery. Type I individuals had a body mass index less than 28, type II individuals had a body mass index between 28 and 32, and type III individuals had a body mass index greater than 32. Results: Type I and II patients in many instances achieved a nearly ideal body contour. Type II and III individuals also had a significant functional and aesthetic improvement but were more likely to have complications. The overall complication rate was 50.0 percent. The most frequent complications were skin dehiscence and seroma formation at 32.5 percent and 16.5 percent, respectively. Conclusions: The body lift very effectively addresses the functional and aesthetic concerns of the massive weight loss patient. Careful patient selection and education are essential to a good outcome. (Plast.

BACKGROUND. Dissecting cellulitis of the scalp (DCS) is a therapeutically challenging, chronic, progressive, suppurative disease of the scalp that is of unknown etiology. In addition to causing considerable discomfort and cosmetic disfigurement, long-standing lesions may result in the development of squamous cell carcinoma. Several treatment modalities for DCS have been employed with variable results. OBJECTIVE. To report the successful treatment of an aggressive, refractory case of DCS with complete scalp excision and splitthickness skin graft. METHODS.A 25-year-old black male with DCS was treated with complete scalp excision and split-thickness graft from the anterior thighs. RESULTS. The patient has remained free of disease activity and is satisfied with the cosmetic result. CONCLUSION. Complete scalp excision with split-thickness skin graft may be curative in patients with DCS and should be considered in recalcitrant cases that fail to respond to medical therapy.