Retrospective analysis of the predictive factors associated with good surgical outcome in brachioplasty in massive weight loss patients

Marchica, Paolo; Bassetto, Franco; Pavan, Chiara; Marini, Massimo; Raimondi, Alfredo M; Gardener, Caterina; Grigatti, Martina; Pagani, Andrea; Brambullo, Tito; Zocchi, Michele L.; Vindigni, Vincenzo

doi:10.1080/2000656x.2020.1788043

Cited by 5 publications

(6 citation statements)

References 32 publications

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“…On the contrary, the portable incision NPWT may have lessen the risk. Although the scarring was from the functional point of view extremely satisfactory and comparable in both groups, according to our previous experience [29], the hyperchromic scar is an aesthetic aspect that should not be underestimated, especially in post-bariatric female patients. VL Young et al [34] indicates that patients are highly about scarring following routine surgery.…”

Section: Discussionmentioning

confidence: 63%

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The Role of Portable Incisional Negative Pressure Wound Therapy (piNPWT) in Reducing Local Complications of Post-bariatric Brachioplasty: A Case-Control Study

et al. 2021

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Background Due to the great impact of bariatric surgery on the overweight epidemic, the number of post-bariatric body-contouring procedures is constantly increasing worldwide. The portable incisional negative pressure wound therapy (piNPWT) is a promising medical device for accelerating wounds closure and controlling post-operative complication, which have been shown promising results in post-bariatric population. We aimed to evaluate the role of piNPWT in optimizing wound healing and controlling post-operative complications after a post-bariatric brachioplasty. Patients and Methods 26 post-bariatric female patients who underwent a brachioplasty followed by either a piNPWT (14 cases) or a standard wound treatment (12 controls) were analyzed. The number of post-operative dressing changes, the rate of local post-operative complications (re-operation, hematoma and serosa development, dehiscence and necrosis), the time to dry as well as the scar quality and hospitalization length were evaluated. Results None of the patients prematurely stopped treatment with piNPWT due to intolerance. The piNPWT patient group showed a significant lower healing time as well as a significant reduction of the number of post-operative dressing changes and hospital stay. Despite the scarring process was excellent from the functional point of view in the long term, we noticed a higher rate of hyperchromic scarring at 90 days after surgery. Conclusion The piNPWT is a cost-effective and user-friendly medical tool that increase and promote wound healing. We suggest the use of this device in post-bariatric patients who undergo a brachioplasty, especially if there is the need to minimize the number of post-operative dressing changes. Level of Evidence IV This journal requires that authors assign a level of evidence to each article. For a full description of these evidence-based Medicine ratings, please refer to Table of Contents or the online Instructions to Authors www.springer.com/00266.

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Section: Discussionmentioning

confidence: 63%

“…In addition, according to our previous experience, BMI greater than 30 kg/m 2 appeared to be negative influence scarring process. Furthermore, concomitant bodycontouring procedures seem to increase post-operative complications [29]. Greater BMI loss has been reported as risk factor for the need of longer incisions and operative time [30].…”

Section: Discussionmentioning

confidence: 99%

The Role of Portable Incisional Negative Pressure Wound Therapy (piNPWT) in Reducing Local Complications of Post-bariatric Brachioplasty: A Case-Control Study

et al. 2021

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Section: Discussionmentioning

confidence: 94%

“…14 Marchica et al reported higher complication rates in patients with MWL due to dietary, metabolic, or psychosocial issues and combined surgery. 15 However, the statistical results of Levan and Bassilios Habre showed no significant increase in complication rate when more than one procedure is combined. 12 In their comparative study between the combination and the noncombination of autogluteal flap augmentation with belt lipectomy, Levan and Bassilios Habre reported that postoperative projection of the belt lipectomy-only procedure was less than that of the autoflap augmentation.…”

Section: Discussionmentioning

confidence: 94%

Gluteal Region Reshaping of Massive Weight Loss Patients—A Decision-Making Strategy

et al. 2022

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Background Massive weight loss (MWL) is a very common presentation that you may face as a plastic surgeon. Each patient has his own individual criteria, so, you should work according to a well-organized plan, especially when such cases have concerns about their gluteal area contour that were neglected before by many surgeons. A decision-making strategy was used to give a personalized treatment for targeting gluteal region reshaping of MWL patients. Methods This study considered all patients with MWL subjected to buttock reshaping. There was no randomization in treatment; there was a case-by-case assessment. We analyzed the features of the buttocks, the type of surgery performed, the outcomes, and the complications. Results Fifty two patients were included (41 females and 11 males), ages ranged between 21 and 66 years. Demographic data, preoperative body mass index (BMI), duration of surgery, type of surgery, and postoperative complications were collected. Statistically significant improvements were observed in gluteal ptosis and patient satisfaction grades. Conclusion Aesthetic improvement of the buttocks involves either augmentation or contouring that may be obtained by liposculpture, surgical lifting, or combination. Patients with MWL have high expectations and are often treated with multiple procedures. Thus, an easy strategic approach personalized on each patient to treat multiple adjacent areas in one operation is necessary. Adipose tissue distribution, gluteal skin status, and BMI were the main factors that can forcefully affect our plan to guarantee reduction of unpleasant results and complications and improve patient satisfaction.

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“…6 and 7, demonstrating patients presenting from other practices with dissatisfaction with scar placement). In previous retrospective reviews, the incidence of unsatisfactory scars after brachioplasty ranged from 24% to 25%, with risk factors including BMI, degree of BMI change after weight loss surgery, and diabetes 11,20 . Hypertrophic or unsatisfactory scars are one of the leading complaints leading to patients seeking revision surgery after brachioplasty 11 .…”

Section: Discussionmentioning

confidence: 99%

A Personal Approach to Brachioplasty

Sergesketter

Erdmann

2022

Ann Plast Surg

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Brachioplasty has become one of the fastest-growing aesthetic surgery procedures, paralleling rising rates of weight loss surgery nationally. However, controversy persists regarding incision placement and utility of concurrent liposuction. In this article, the authors describe indications, patient selection, expected outcomes, and photographic standards for patients seeking brachioplasty after weight loss. Preoperative markings, scar placement, and operative steps of a posterior incision technique with or without concurrent liposuction if indicated are described. A personal experience with posterior incision brachioplasty along with current controversies, complications, and patient-reported outcomes after upper arm contouring are reviewed.

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Retrospective analysis of the predictive factors associated with good surgical outcome in brachioplasty in massive weight loss patients

Cited by 5 publications

References 32 publications

The Role of Portable Incisional Negative Pressure Wound Therapy (piNPWT) in Reducing Local Complications of Post-bariatric Brachioplasty: A Case-Control Study

The Role of Portable Incisional Negative Pressure Wound Therapy (piNPWT) in Reducing Local Complications of Post-bariatric Brachioplasty: A Case-Control Study

Gluteal Region Reshaping of Massive Weight Loss Patients—A Decision-Making Strategy

A Personal Approach to Brachioplasty

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