Complications after Body Contouring Surgery in Post-Bariatric Patients: The Importance of a Stable Weight Close to Normal

Abstract

Objective: Body contouring surgery is in high demand following the increase in bariatric surgery. Massive weight loss leads to an excess of lax, overstretched skin causing physical and psychosocial discomfort. Plastic surgical procedures can give rise to an improvement in quality of life, but the relative high complication rate could negatively affect these potential gains. The purpose of this study is to identify predictors of complications in order to optimize outcomes in this patient population. Methods: Out of a group of 465 post-bariatric patients, 61 patients underwent body contouring surgery following massive weight loss. A total of 43 respondents were reviewed retrospectively for demographic data, pre- and post-operative weight status and co-morbidities. Medical complications were categorized according to the modified Clavien classification. All cases were analyzed for risk factors. Results: A stable weight over a period of at least 3 months prior to body contouring surgery is associated with a significant lower complication rate (odds ratio 0.24; CI 0.07–0.79) and the percentage excess weight loss (odds ratio 0.96; 95% CI 0.92–1.00) was an independent predictor for the occurrence of complications. The overall complication rate was 27.9% with a major complication rate of 8.8%. Most frequent procedures were abdominoplasty (61%) and breast reduction/ mammapexy (25%). Conclusion: This study emphasizes the importance to strive for a stable weight close to normal before surgery to minimize the risk of complications. The positive effects of the long-term results of bariatric surgery tolerate the relative high complications rate. Careful pre-operative planning and patient selection are essential to optimize the results of body contouring surgery of post-bariatric patients.

Medial Thighplasty After Massive Weight Loss: Are There Any Risk Factors for Postoperative Complications?

“…In this case they have to accept a higher risk of complications during the surgical procedure. In our opinion, based on the literature, the most important point is to get a stable weight on a period of at least 6 months before thighplasty and a stop of the tobacco consumption [26,27].…”

Textbook of Plastic and Reconstructive Surgery

“…A stable pre-operative weight has, again, been shown to reduce the risk of complications after body contouring surgery compared with variable and unstable body weights (van der Beek et al, 2011). This concept is more applicable to massive weight loss patients who have been previously overweight or obese; however, stable weight maintenance before body contouring is a key consideration for all patient groups in general.…”

Plastikkirurgi etter fedmekirurgi

“…Plastikkirurger setter ofte øvre BMIgrense for kroppsformende kirurgi ved 30 kg/m 2 grunnet frykt for komplikasjoner og fordi fjerning av hud er enklere hvis det ikke er mye fett i tillegg (9,26). Enkelte små retrospektive observasjonsstudier støtter dette synet.…”

“…Et cirkumferensielt nedre kroppsløft tar 3 -5 timer og krever 1 -4 dagers innleggelse. Rekonvalesenstiden er normalt 4 -6 uker, såfremt det ikke oppstår komplikasjoner (26,27).…”