Seroma Development following Body Contouring Surgery for Massive Weight Loss: Patient Risk Factors and Treatment Strategies

Shermak, Michele A.; Rotellini-Coltvet, Lisa; Chang, David C.

doi:10.1097/prs.0b013e31817742a9

Cited by 115 publications

(46 citation statements)

References 26 publications

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“…JID: PRAS [m6+; 15:22 ] bariatric patients typically ranges from 9% to 18%. 20,31,33,34 However, contrary to previous studies, wherein postbariatric surgery patients have a 60% to 87% increased risk of complications compared with non-bariatric patients who lost weight through changes in dietary habits or through exercise, 27 our results contradict this somewhat. Our groups comparing bariatric and non-bariatric patients were similar in terms of both weight and weight loss.…”

Section: Article In Presscontrasting

confidence: 99%

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

Pajula

Jyränki

Tukiainen

et al. 2019

Journal of Plastic, Reconstructive & Aesthetic Surgery

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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.

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Section: Article In Presscontrasting

confidence: 99%

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

Pajula

Jyränki

Tukiainen

et al. 2019

Journal of Plastic, Reconstructive & Aesthetic Surgery

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“…[10] In our series six patients (4%) had seroma which needed aspiration three times to dry out the seroma. All these patients had a fatty abdominal wall more than 6-cm thick.…”

Section: Resultsmentioning

confidence: 91%

“…Although the higher BMI did not increase the wound or systemic complications in women,[10] seroma and fat necrosis were commoner both in men and women when fat thickness was more than 8 cm. The open liposuction before skin closure to achieve a fat thickness between 3 and 5 cm reduced the incidence of fat necrosis and seroma.…”

Section: Discussionmentioning

confidence: 99%

Lipoabdominoplasty: An exponential advantage for a consistently safe and aesthetic outcome

Kanjoor¹,

Singh²

2012

Indian J Plast Surg

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Background:Extensive liposuction along with limited dissection of abdominal flaps is slowly emerging as a well proven advantageous method over standard abdominoplasty.Materials and Methods:A retrospective study analyzed 146 patients managed for the abdominal contour deformities from March 2004 to February 2010. A simple method to project the post operative outcome by rotation of a supine lateral photograph to upright posture in 46 patients prospectively has succeeded in projecting a predictable result. All patients were encouraged to practice chest physiotherapy in ‘tummy tuck’ position during the preoperative counseling. Aggressive liposuction of entire upper abdomen, a limited dissection in the midline, plication of diastasis of rectus whenever indicated, panniculectomy and neoumblicoplasty were done in all patients.Results:The patients had a mean age of 43, youngest being 29 and oldest 72 years. Majority were of normal weight (94%). Twelve were morbidly obese; 57 patients had undergone previous abdominal surgeries; 49 patients had associated hernias. Lipoabdominoplasty yielded a satisfactory result in 110 (94%) patients. The postoperative patient had a definitely less heavy harmonious abdomen with improved waistline. The complications were more with higher BMI, fat thickness of more than 7 cm and prolonged operating time when other procedures were combined.Conclusions:Extensive liposuction combined with limited dissection method applied to all abdominoplasty patients yielded consistently safe, reliable and predictable aesthetic results with less complications and faster recovery. The simple photographic manipulation has helped project the postoperative outcome reliably. The preoperative chest physiotherapy in tummytuck position helped prevent chest complications.

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“…Shermak investigated complications following body contouring procedures and reported seroma occurrence in 4% of patients following thigh lift. 21…”

Section: Post-bariatric Body Contouring Procedures and Outcomesmentioning

confidence: 99%

Advances in weight loss surgery and body contouring after weight loss

Herman¹,

Hoschander²,

Teleo³

et al. 2010

OAS

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Surgical treatment for morbid obesity has been increasing over the last few years. Historically, bariatric surgery had been plagued by complications, both technical and metabolic. The criteria to decide if a patient should have bariatric surgery required that the patient's morbid obesity was contributing to an otherwise imminent demise. Now, with improved techniques, laparoscopic surgery and better understanding of the metabolic consequences of bariatric surgeries, it is presumed that the benefits outweigh the risks of bariatric surgery in increasing numbers of patients. Additionally, the post-bariatric procedures for body contouring have many documented complications. Most of these can be related to the nutritional status of obese patients and the relative immunodeficiency that obese patients possess. After a thorough literature search it appears that bariatric surgery and post-bariatric body contouring are, indeed, safer than previously thought.

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Seroma Development following Body Contouring Surgery for Massive Weight Loss: Patient Risk Factors and Treatment Strategies

Abstract: The most important risk factor for seroma is weight of skin excised at the time of surgery. Treatment strategies include aspiration, drain placement, sclerosis, and surgery.

Cited by 115 publications

References 26 publications

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

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

Lipoabdominoplasty: An exponential advantage for a consistently safe and aesthetic outcome

Advances in weight loss surgery and body contouring after weight loss

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