Aesthetic Refinements in Body Contouring in the Massive Weight Loss Patient

Shermak, Michele A.

doi:10.1097/prs.0000000000000627

Cited by 21 publications

(8 citation statements)

References 46 publications

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“…In the last couple of years, a dramatic evolution in arm contouring procedures had been witnessed in the published data due to an increase in the population's demand to achieve the perfect body besides the substantial awareness of losing weight [ 9 ]. Nearly those methods were just modifications in brachioplasty length, position, and design in an attempt to minimize the incision complications and improve outcome [ 11 ].…”

Section: Discussionmentioning

confidence: 99%

“…A literature review, done by Shermak A. in 2014, had shown different approaches and classification systems that vary according to patient presentation and the author's opinion and most of them are forms of brachioplasty that may include liposuction in single or two stages, which reveals a lack of consensus. He emphasized that the most annoying factor in brachioplasty is patient consciousness about the presence and the location of the scar especially when it is complicated with hypertrophy [ 9 ]. El-Khatib classified brachioplasty according to the amount of adipose tissue deposit and the degree of ptosis in which stage I has a minimal amount of adipose tissue without skin ptosis; stage IIA has a moderate amount of adipose tissue with skin ptosis less than 5 cm (grade I ptosis); stage IIB has a large amount of adipose tissue with skin ptosis of 5–10 cm (grade II ptosis); stage III has a large amount of adipose tissue with skin ptosis greater than 10 cm (grade III ptosis), and stage IV has a minimal amount of adipose tissue with grade III ptosis [ 10 ].…”

Section: Introductionmentioning

confidence: 99%

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Ultrasound-Assisted Liposuction (UAL) Arm Contouring in Non-Post-Bariatric Patients: No Rush for Brachioplasty

Fahar

El-Gharbawi²

2022

Aesth Plast Surg

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Background A witnessed rise in patients’ requests for arm contouring reflects the parallel public’s pursuit of slimmed bodies and rapid advancement in weight reduction methods. Brachioplasty with its known complications is still the traditional method of management, but nearly all patients feel worried about the length and appearance of the scar and seek other non-excisional alternatives. The authors wanted to share their experience in arm contouring in non-post-bariatric patients using ultrasound-assisted liposuction (UAL). Patients and Methods Over 16 month period, 28 female patients complaining of arm lipodystrophy (classes IIA, IIB, III) underwent UAL contouring under general anesthesia. Preoperative and postoperative mid-arm circumferences were measured and recorded. Outcome evaluation was done by the complication incidence, patient satisfaction survey, and independent surgeon evaluation of patients' photographs. Results There were no complications in the study group. The outcome evaluation survey has shown high patient satisfaction. The outcome survey demonstrated that 85.71% of the patients were very satisfied, while 14.29 % were satisfied with the procedure and all of them recommend the procedure to others. On the other hand, the independent surgeon evaluation showed that 92.86% of the results were excellent and 7.14 % were very good. Conclusion Our work has shown how versatile is the UAL in contouring a wide spectrum of arm lipodystrophy stages in non-post-bariatric patients and presents a non-excisional alternative for arm aesthetic refinements without a rush for brachioplasty with its unpleasant 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 the Table of Contents or the online Instructions to Authors www.springer.com/00266.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Ultrasound-Assisted Liposuction (UAL) Arm Contouring in Non-Post-Bariatric Patients: No Rush for Brachioplasty

Fahar

El-Gharbawi²

2022

Aesth Plast Surg

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“…Bariatric surgery causes various changes in the corporal configuration of the patients who choose to be treated with this therapy. 10,11 However, knowledge regarding the impact of this treatment in terms of facial appearance, and the changes that the facial skin undergoes following abrupt massive reduction in body weight, is still lacking. In the first year after bariatric surgery, there is a sudden and intense change in the weight of the respective patients.…”

Section: Discussionmentioning

confidence: 99%

Influence of Massive Weight Loss on the Perception of Facial Age: The Facial Age Perceptions Cohort

Valente

Silva

Mottin

et al. 2018

Plastic &Amp; Reconstructive Surgery

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Background: Knowledge is scarce about the role of massive weight loss in facial age perception. The aim of this study was to verify whether there is a change in the perception of facial age when comparing people with morbid obesity before surgery and 1 year after the procedure. Methods: Patients with morbid obesity have been analyzed, through a prospective cohort, before and 1 year after undergoing bariatric surgery. Seven plastic surgeons estimated the age of each subject. Results: Seventy patients participated. Five patients were excluded because of the exclusion criteria. There was no drop-off among the subjects participating in this cohort. Before surgery, the mean facial age perception was 40.8 years; after surgery, mean facial age perception was 43.7 years (95 percent CI, 0.58 to 2.95; p = 0.004). Men older than 40 years, with a preoperative body mass index between 40 and 49.9 kg/m 2 , weight greater than 127.65 kg before surgery, and percentage of excess weight lost greater than 75.13 percent demonstrated greater perceived facial aging. Conclusion: Massive weight loss appears to produce facial aging. (Plast. Reconstr. Surg. 142: 481e, 2018.) CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, IV.

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“…Traditional brachioplasty with scar placement over the bicipital groove, with or without extension to the lateral chest wall, is one of the most commonly used approaches. An alternative to the placement of the scar on the bicipital groove is brachioplasty with a posterior or postero-medial scar [ 10 , 11 , 12 , 13 , 14 ]. The incision patterns can be different, resulting in a straight-line scar, a T-shaped scar, a W-shaped scar, an L-shaped scar, or an S-shaped scar.…”

Section: Introductionmentioning

confidence: 99%

The Jaws Brachioplasty: An Original Technique: Improving Aesthetic Outcomes in Arm Lift Procedures

Nisi

Giardino

Giudice

et al. 2022

JCM

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(1) Background: The increase in the number of bariatric surgery procedures has led plastic surgeons to look for new approaches to improve outcomes of body-contouring surgeries. A major concern in brachioplasty is the scarring process. Here, we propose a novel technique to minimize the incidence of pathological or unsatisfactory scars from brachioplasty. A video of the entire procedure is provided. (2) Methods: From January 2016 to August 2020, we performed the “Jaws” brachioplasty on 16 post-bariatric patients. We evaluated the effectiveness of the technique through pre- and postoperative assessments by patients and surgeons, the Vancouver Scar Scale, and the detection of major and minor complications within 12 months of follow-up. (3) Results: Thirteen patients were female and three were male, with a mean age of 32.5 ± 6.8 years (range: 22–47 years). The BODY-Q© Arms Section scores improved significantly, with no incidence of major or minor complications over 1 year of follow-up, and favorable aesthetic outcomes. (4) Conclusions: We believe that the “Jaws” technique is a valid contribution to post-bariatric surgery, as it aims to solve specific aesthetic problems of scarring from brachioplasty. The small number of patients does not allow the comparison of our original technique to others previously described in the literature.

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Aesthetic Refinements in Body Contouring in the Massive Weight Loss Patient

Abstract: This literature review has elucidated multiple approaches to brachioplasty, and the pearls and pitfalls described may all be incorporated to produce excellent outcomes and patient satisfaction in an individualized approach.

Cited by 21 publications

References 46 publications

Ultrasound-Assisted Liposuction (UAL) Arm Contouring in Non-Post-Bariatric Patients: No Rush for Brachioplasty

Ultrasound-Assisted Liposuction (UAL) Arm Contouring in Non-Post-Bariatric Patients: No Rush for Brachioplasty

Influence of Massive Weight Loss on the Perception of Facial Age: The Facial Age Perceptions Cohort

The Jaws Brachioplasty: An Original Technique: Improving Aesthetic Outcomes in Arm Lift Procedures

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