Outpatient-Based Massive Weight Loss Body Contouring: A Review of 260 Consecutive Cases

Egrari, Sepehr

doi:10.1177/1090820x12441618

Cited by 13 publications

(7 citation statements)

References 17 publications

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“…20,21 Studies showing that certain outpatient plastic surgery operations have low mortality rates and complication profiles compared to corresponding inpatient procedures have only helped expand on these associated advantages. [20][21][22][23][24][25][26] A transition to outpatient surgery is important to health care reform, as it is associated with lower costs. 27 Nevertheless, little is known about readmission rates in this setting, and without such critical outcomes data, it will be more difficult to improve processes (and thereby avoid potential future punitive action from regulatory agencies).…”

mentioning

confidence: 99%

Predictors of Readmission after Outpatient Plastic Surgery

Mioton

Buck

Rambachan

et al. 2014

Plastic and Reconstructive Surgery

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Unplanned readmission after outpatient plastic surgery is infrequent and compares favorably to rates of readmission among other specialties. Obesity, wound infection within 30 days of the index operation, and American Society of Anesthesiologists class 3 or 4 physical status are independent predictors of readmission. As procedures continue to transition into outpatient settings and the drive to improve patient care persists, these findings will serve to optimize outpatient surgery use.

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mentioning

confidence: 99%

Predictors of Readmission after Outpatient Plastic Surgery

Mioton

Buck

Rambachan

et al. 2014

Plastic and Reconstructive Surgery

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“…Chemoprophylaxis was not used in any of the cases. This is the second largest study of outpatient BL surgery 5 published and the lowest rate of complications reported.…”

Section: Resultsmentioning

confidence: 86%

“…The long duration of operative time, complex anesthesia management, prolonged postoperative convalescence, and high rates of major and minor complications (24%-78%) associated with inpatient management justifiably delayed consideration of these procedures for outpatient care. 1-25…”

Section: Introductionmentioning

confidence: 99%

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An Enhanced Recovery After Surgery (ERAS) Protocol for Outpatient BodyLift Surgery

Nuveen

Matthesen²,

Cox

et al. 2020

Am J Cosmet Surg

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The concept of enhanced recovery after surgery (ERAS) was developed in 2001 in order to create a multimodal, scientifically based approach to the development and audit of protocols for improving outcomes after surgical procedures. These protocols undergo constant evolution and evaluation toward the goal of quality of recovery. The BodyLift (BL) is the procedure that most comprehensively addresses the cosmetic needs of patients after massive weight loss (MWL). In the course of performing 136 consecutive outpatient BL surgeries over 7 years, we have developed a management protocol that has provided consistently high patient satisfaction, minimized frequent complications, and has documented 100% safety in all cases performed without deep vein thrombosis (DVT), transfusion and with 1 postoperative hospital admission. Each evidence-based component in the protocol was instituted to reduce risk of complications known to be most commonly associated with circumferential body contouring surgery. ERAS protocols are now widely used in many other surgical subspecialties. These protocols have the common goal of returning the patient to normal function as expeditiously as possible and are associated with decreased complications as well as shorter length-of-stay (LOS) and reduced costs. We have enumerated the many components of our protocol and aligned each with elements of an ERAS paradigm. In our retrospective review of 7 years of BL surgery (n = 136), this protocol has reduced both major and minor complications to previously unpublished levels. Our independently formulated ERAS protocol for outpatient BL surgery aligns closely with the ERAS concept, limiting surgical stress, thus reducing complications and affording a smooth and predictable perioperative experience. This is of importance for elective cosmetic surgery patients, who often have high expectations for an uneventful recovery and are unaccepting of potentially out-of-pocket costs associated with complications.

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“…In recent years, the Food and Drug Administration has approved several different outpatient treatment therapies for obesity. Hence, the bariatric surgery estimate in this study is an underestimation as many of those surgeries (typically gastric bands and sleeve gastrectomy) are now done in an outpatient setting 40,41 . Also, non‐surgical treatments for obesity, including gastric balloons and other procedures performed by gastroenterologists and others, are increasingly common, which we could not identify in our in‐patient database.…”

Section: Discussionmentioning

confidence: 92%

In‐patient obesity diagnosis, use of surgical treatment and associated costs by payer type in the United States: Analysis of the National Inpatient Sample, 2011 through 2014

et al. 2020

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Summary This study aims to examine the trend in the diagnosis of obesity and the use of surgical treatment in in‐patient settings as well as per person and national costs associated with the surgical treatment of obesity. We conducted cross‐sectional and trend analyses of in‐patient obesity diagnosis and surgical treatment for obesity using data from the National Inpatient Sample (2011‐2014) of adult patients in the United States aged 18 years and older. We studied the rate of in‐patient obesity diagnosis among hospitalized patients, the rate of bariatric surgery among patients diagnosed with obesity in the hospital, and the costs associated with surgical treatment. Trend analyses showed a statistically significant increase in the proportion of (a) hospitalized patients diagnosed with obesity, and (b) bariatric surgery among those diagnosed with obesity and among different socio‐demographic and insurance groups. Despite the increase in the national in‐patient cost, the average in‐patient cost per hospitalization associated with bariatric surgery decreased from 2012 to 2014. With the increase in the rate of diagnosed obesity and bariatric surgery among hospitalized patients and the decrease in the average in‐patient cost, future research should address the short‐ and long‐term cost‐effectiveness of bariatric surgery on chronic diseases.

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Outpatient-Based Massive Weight Loss Body Contouring: A Review of 260 Consecutive Cases

Abstract: 4.

Cited by 13 publications

References 17 publications

Predictors of Readmission after Outpatient Plastic Surgery

Predictors of Readmission after Outpatient Plastic Surgery

An Enhanced Recovery After Surgery (ERAS) Protocol for Outpatient BodyLift Surgery

In‐patient obesity diagnosis, use of surgical treatment and associated costs by payer type in the United States: Analysis of the National Inpatient Sample, 2011 through 2014

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