Complications of Lower Body Lift Surgery in Postbariatric Patients

Abstract

Background:There is an exponential rise of patients with massive weight loss because of bariatric surgery or lifestyle changes. The result is an increase of patients with folds of redundant skin that may cause physical and psychological problems. The lower body lift is a procedure to correct deformities in the abdomen, mons, flanks, lateral thighs, and buttocks. Complication rates are quite high and could negatively affect the positive outcomes. The purpose of this study is to assess complication rates and to identify predictors of complications to optimize outcomes for patients after lower body lift surgery.Methods:A retrospective analysis of 100 patients who underwent a lower body lift procedure was performed. The patients were reviewed for complications, demographic data, comorbidities, smoking, highest lifetime body mass index, body mass index before lower body lift surgery, percentage of excess weight loss, and amount of tissue excised.Results:The overall complication rate was 78%. Twenty-two percent of the patients had major complications and 56% had minor complications. There is a linear relationship between body mass index before lower body lift surgery and complications (P = 0.03). The percentage of excess weight loss (odds ratio [OR] 0.97; 95% confidence interval [CI] 0.92–1.00), highest lifetime body mass index (OR 1.08; 95% CI 1.01–1.15), body mass index before lower body lift surgery (OR 1.17; 95% CI 1.02–1.33), and smoking (OR 7.74; CI 0.98–61.16) are significantly associated with the development of complications.Conclusions:This study emphasizes the importance of a good weight status before surgery and cessation of smoking to minimize the risk of complications.

Complications after lower body contouring surgery due to massive weight loss unaffected by weight loss method

“…JID: PRAS [m6+; 15:22 ] bariatric patients typically ranges from 9% to 18%. 20,31,33,34 However, contrary to previous studies, wherein postbariatric surgery patients have a 60% to 87% increased risk of complications compared with non-bariatric patients who lost weight through changes in dietary habits or through exercise, 27 our results contradict this somewhat. Our groups comparing bariatric and non-bariatric patients were similar in terms of both weight and weight loss.…”

“…Our findings agree well with those reported in previous studies. In the previous literature, the single most common post-operative complication following lower body contouring surgery consists of seromas, thus accounting for approximately 5% to 15% of all complications, 11-13 , 22 followed by wound-related problems, 22 such as dehiscence 11,20 and skin-edge necrosis. 13 Other complications include haematomas, lymphoceles, deep vein thromboembolism, pulmonary embolism, lymphedema, post-operative anaemia and nerve injuries.…”

“…11,12,20 , 31-33 It seems that the vast majority of complications are minor. However, only a few recent studies 12,20 have applied a systematic approach to classify complications such as the Clavien-Dindo classification. In our study, more than 75% of the complications were classified as late, that is, occurring 7 to 30 days postoperatively.…”

“…11-13 , 20 The majority of complications are minor. 11,12,20 Significant risk factors for post-operative complications following body contouring surgery include a high pre-surgical BMI, a high American Society of Anesthesiologists (ASA) score, the amount of excess weight loss, the amount of tissue removed, intraoperative hypothermia, male gender, older age, smoking and comorbidities such as diabetes and hypertension. [21][22][23][24][25][26] Furthermore, bariatric surgery itself induces malabsorption and nutritional imbalance, 17 thus increasing the complication rate in post-bariatric patients.…”

Lower Body Lift: Manejo integral del tronco inferior en pacientes con baja masiva de peso. Serie de casos y descripción de la técnica quirúrgica

“…Al revisar la literatura, si bien existen múltiples publicaciones (series de casos, estudios de cohorte, revisiones sistemáticas y guías de recomendación) sobre cirugía de contorno corporal en pacientes con baja masiva de peso, existen pocas series destinadas en forma exclusiva a analizar pacientes con Lower Body Lift [21][22][23] .…”