Incidence and Risk Factors of Major Complications in Brachioplasty: Analysis of 2,294 Patients

Nguyen, Lyly; Gupta, Varun; Afshari, Ashkan; Shack, R. Bruce; Grotting, James C.; Higdon, Kent

doi:10.1093/asj/sjv267

Cited by 35 publications

(17 citation statements)

References 38 publications

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“…45 On the other hand, Nguyen et al in an analysis of 2294 patient who underwent brachioplasty showed an increase in hematomas with combined procedures (1.6% vs 0.1%, P < 0.01), and combined procedures were found to be an independent predictor for postoperative hematomas. 46 Similarly, our analysis has demonstrated that combined procedures are an independent predictor for hematoma formation. A possible explanation for this finding is the increased operative time with each additional procedure, as shown by prior series.…”

Section: Risk Factorssupporting

confidence: 60%

Incidence and Risk Factors for Major Hematomas in Aesthetic Surgery: Analysis of 129,007 Patients

Kaoutzanis

Winocour

Gupta

et al. 2017

Aesthetic Surgery Journal

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Background: Postoperative hematomas are one of the most frequent complications following aesthetic surgery. Identifying risk factors for hematoma has been limited by underpowered studies from single institution experiences. Objectives: To examine the incidence and identify independent risk factors for postoperative hematomas following cosmetic surgery utilizing a prospective, multicenter database. Methods: A prospectively enrolled cohort of patients who underwent aesthetic surgery between 2008 and 2013 was identified from the CosmetAssure database. Primary outcome was occurrence of major hematomas requiring emergency room visit, hospital admission, or reoperation within 30 days of the index operation. Univariate and multivariate analysis was used to identify potential risk factors for hematomas including age, gender, body mass index (BMI), smoking, diabetes, type of surgical facility, procedure by body region, and combined procedures. Results: Of 129,007 patients, 1180 (0.91%) had a major hematoma. Mean age (42.0 ± 13.0 years vs 40.9 ± 13.9 years, P < 0.01) and BMI (24.5 ± 5.0 kg/m 2 vs 24.3 ± 4.6 kg/m 2 , P < 0.01) were higher in patients with hematomas. Males suffered more hematomas than females (1.4% vs 0.9%, P < 0.01). Hematoma rates were higher in patients undergoing combined procedures compared to single procedures (1.1% vs 0.8%, P < 0.01), and breast procedures compared to body/extremity or face procedures (1.0% vs 0.8% vs 0.7%, P < 0.01). On multivariate analysis, independent predictors of hematoma included age (Relative Risk [RR] 1.01), male gender (RR 1.98), the procedure being performed in a hospital setting rather than an office-based setting (RR 1.68), combined procedures (RR 1.35), and breast procedures rather than the body/extremity and face procedures (RR 1.81). Conclusions: Major hematoma is the most common complication following aesthetic surgery. Male patients and those undergoing breast or combined procedures have a significantly higher risk of developing hematomas.

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Section: Risk Factorssupporting

confidence: 60%

Incidence and Risk Factors for Major Hematomas in Aesthetic Surgery: Analysis of 129,007 Patients

Kaoutzanis

Winocour

Gupta

et al. 2017

Aesthetic Surgery Journal

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“… 11 In fact, the proportion of operative hematomas overall (around 1%) is more consistent with previously published reports on hematoma incidence in the literature, suggesting the possibility that the literature has a tendency to analyze operative over nonoperative hematomas. 25 , 26 The difference in conclusions between nonstratified and stratified hematoma data suggests that researchers should be more critical of studies that do not divide hematoma incidence into subgroups. These findings further emphasize that hematoma requiring re-operation is an inaccurate indicator of overall hematoma incidence, and it is essential for future studies to document and include minor hematomas treated in the outpatient setting to fully understand hematoma risk in this patient population.…”

Section: Discussionmentioning

confidence: 99%

Body Contouring in Massive Weight Loss Patients Receiving Venous Thromboembolism Chemoprophylaxis: A Systematic Review

Yin¹,

McAuliffe²,

Marquez³

et al. 2021

Plastic and Reconstructive Surgery - Global Open

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Background: Venous thromboembolism (VTE) events are the leading cause of morbidity and mortality in plastic surgery. Currently, there is no consensus regarding the use of VTE chemoprophylaxis in the context of the risk for bleeding following specific body contouring procedures. Furthermore, there is increasing popularity of these procedures in the massive weight loss (MWL) patient population, who may be at higher risk due to multiple risk factors. The purpose of this study was to stratify the incidence of VTE and bleeding events among individual, specific body contouring procedures in MWL patients receiving chemoprophylaxis. Methods: A systematic review was designed according to PRISMA guidelines. We screened all articles published between 1988 and 2018 reporting chemoprophylaxis status, VTE, and bleeding events in MWL patients undergoing body contouring procedures. Results: Thirty-one publications were reviewed. The VTE incidence for any procedure was too low to reach significance. Overall, hematoma incidence in single-procedure patients (8.7%) was significantly higher than concomitant-procedure patients (4.2%, P < 0.01). However, when stratified into operative and nonoperative hematomas, no significant difference between single- and concomitant-procedure groups overall was demonstrated for either category. Individually, only thighplasty patients had a higher rate of operative hematomas when undergoing thighplasty alone (5.3%) compared with thighplasty with concomitant procedures (0.6%, P < 0.05). Conclusions: Overall, MWL patients undergoing single body contouring procedures (among abdominoplasty, belt lipectomy, thighplasty) were found to have a higher risk of hematoma compared with those undergoing combined contouring procedures. However, stratified hematoma data revealed no differences in overall risk between single- and multiple-procedure operations.

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“…58 Poor excisional design is a frequent cause for undercorrection of redundant skin and subcutaneous fat during primary brachioplasty occurring in about 12% of patients. 59 This may be seen in patients who are treated using a small, transverse scar in an attempt to minimize the size of the final scar. Wide and thick scarring is frequently seen postoperatively in patients who undergo brachioplasty, with 11% to 41% of patients developing hypertrophic scar tissue.…”

Section: Upper Extremitymentioning

confidence: 99%

“…Wide and thick scarring is frequently seen postoperatively in patients who undergo brachioplasty, with 11% to 41% of patients developing hypertrophic scar tissue. 58,59 In contrast to other contour irregularities, aesthetically displeasing scars following brachioplasty are largely unavoidable due to the magnitude of the tensile forces imposed on the incision site. [60][61][62] Plastic surgeons largely compensate for this complication by placing the scar where it is least visible.…”

Section: Upper Extremitymentioning

confidence: 99%

“…50,62 Wound dehiscence occurs in approximately 3% to 23% of patients who undergo brachioplasty for reasons similar to that of aesthetically displeasing scars. 58,59 Many patients have wound dehiscence at the axillary component of the incision line due to the wide range of motion exhibited by the glenohumeral joint. Layered closure of wound edges and strict movement restrictions minimize the risk of dehiscence.…”

Section: Upper Extremitymentioning

confidence: 99%

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Avoidance and Correction of Deformities in Body Contouring

et al. 2021

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Body contouring procedures are highly impactful because of their potential to improve a patient's quality of life. These procedures, particularly when performed on patients following massive weight loss, may require secondary intervention to treat residual contour abnormalities. Presently, there is a paucity of information in the literature detailing the avoidance and correction of body contouring deformities. Herein, we will discuss the management of patients seeking revisional body contouring procedures.

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Incidence and Risk Factors of Major Complications in Brachioplasty: Analysis of 2,294 Patients

Abstract: Complication rates from brachioplasty are much lower than previously reported. Hematoma and infection are the most common major complications. Combined procedures, male gender, and BMI ≥ 30 kg/m(2) are independent risk factors for complications. LEVEL OF EVIDENCE 2: Risk.

Cited by 35 publications

References 38 publications

Incidence and Risk Factors for Major Hematomas in Aesthetic Surgery: Analysis of 129,007 Patients

Incidence and Risk Factors for Major Hematomas in Aesthetic Surgery: Analysis of 129,007 Patients

Body Contouring in Massive Weight Loss Patients Receiving Venous Thromboembolism Chemoprophylaxis: A Systematic Review

Avoidance and Correction of Deformities in Body Contouring

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