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

Abstract

Body contouring surgery following massive weight loss positively affects a patient's quality of life. However, the procedure is prone to complications. Herein, we stratified complications timewise. Furthermore, we examined whether the weight loss method -bariatric surgery or lifestyle changes -affected the frequency or severity of complications. In this single-centre retrospective analysis, we included 158 patients with massive weight loss undergoing body contouring surgery between 2009 and 2015. We recorded 96 complications in 80 patients, with an overall rate of 51%. Most complications (80.2%) were minor (Clavien-Dindo grades 1 and 2) and superficial wound infections. Immediate complications (0-24 hours postoperation) affected 8.3% of patients, with early complications (1-7 post-operative days) affecting 16.7% of them and late complications (8-30 post-operative days) affecting 58.3% of them. We found no statistical difference in complication rates when comparing bariatric and nonbariatric patients. Older age (p = 0.042) at operation is associated with an increased risk for immediate haematoma or bleeding requiring surgery. Among early complications, a high maximum weight (p = 0.035) and a high preoperative weight (p = 0.0053) significantly correlated with a haematoma or bleeding requiring surgery. For late complications, seroma correlated with older age (p = 0.0061). Complications are primarily minor and non-life threatening after body contouring surgery because of frequent massive weight loss. Here, no particular subgroup of massive weight loss patients appeared more prone to complications. Thus, for each patient, the risks associated with body contouring surgery following massive weight loss should be considered individually.

Risk factors and complications after body‐contouring surgery and the amount of stromal vascular fraction cells found in subcutaneous tissue

“…In summary, bariatric patients did not suffer more complications than the patients from the lifestyle group, especially not more severe complications Clavien‐Dindo °3 requiring surgical intervention. This reflects the results from other groups found in the literature. Surprisingly, our data do not support the hypothesis that patients do suffer more complications after undergoing bariatric surgery.…”

“…In postbariatric patients, the mean resection weight was higher than in the lifestyle group without statistical significance ( P = .057). However, a significant correlation was found between preoperative BMI and weight of resected tissue ( P = .031) in concord with the results of other groups . Patients presented with a mean BMI of 25.3 kg/m 2 at the time point of surgery (range 36.42‐18.82).…”

“…However, a significant correlation was found between preoperative BMI and weight of resected tissue (P = .031) in concord with the results of other groups. 23,32 Patients presented with a mean BMI of 25.3 kg/m 2 at the time point of surgery (range 36.42-18.82). Patients that had a normal BMI ranging between 20 and 25 at this time point sustained significantly less wound healing complications than those with a higher BMI (P = .031).…”

“…Up to 35% of bariatric patients suffer of folate and vitamin B12 deficiency, while especially gastric bypass patients suffer from iron deficiency . Despite malnutrition in postbariatric patients, it could be shown that complication rates of body‐contouring surgery do not vary depending on the weight loss method . Finally, it is has been shown that SVF content and ASC behaviour are altered in the subcutaneous tissue of morbid obese patients, and these changes are not completely restored after bariatric surgery‐induced weight loss.…”

“…18,19 Despite malnutrition in postbariatric patients, 20,21 it could be shown that complication rates of body-contouring surgery do not vary depending on the weight loss method. 22,23 Finally, it is has been shown that SVF content and ASC behaviour are altered in the subcutaneous tissue of morbid obese patients, 24 and these changes are not completely restored after bariatric surgery-induced weight loss. Thus, we hypothesised that altered SVF content in the subcutaneous tissue of postbariatric patients is affecting the regenerative effects of wound healing and is therefore linked to an increased complication rate in postbariatric bodycontouring procedures compared with patients that lose weight by means of lifestyle change.…”