What Is the Impact of Residual Obesity on the Risk for Postoperative Body-Contouring Surgery Complications in Postbariat
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What Is the Impact of Residual Obesity on the Risk for Postoperative Body-Contouring Surgery Complications in Postbariatric Patients? Jefferson Lessa Soares de Macedo 1
&
Simone Corrêa Rosa 1,2 & Lucas Ribeiro Canedo 3 & Luiz Augusto Casulari 2
# Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract Background There are an increasing number of patients presenting for plastic surgery after massive weight loss, and many of these patients have residual obesity that may compromise outcomes. The impact of residual obesity on the development of postoperative complications in postbariatric patients undergoing plastic surgery procedures is unclear. Methods We report the outcomes of 207 patients who underwent plastic surgery following RYGB from January 2011 to December 2018. Results Two hundred and seven patients (196 females, 11 males) with a mean age of 42 years underwent 335 separate operations. The average BMI at the time of plastic surgery was 27.43 kg/m2. The average weight loss was 47.08 kg. The prevalence of comorbidities was 26.6% and the most important presurgery comorbidities were arterial hypertension (10.1%) and diabetes mellitus (4.8%). Of the 207 patients who underwent surgery, 78.3% (168/207) underwent abdominoplasty and 45.0% underwent mammoplasty. The overall rate of complications was 27.5%. The prevalence of postoperative complications was not significantly different between patients with a BMI ≥ 30 kg/m2 and patients with a BMI < 30 kg/m2 (33.3% vs 25.9%, respectively; p = 0.344). Conclusion In this group of patients, with specified anthropometric and clinical profiles, the residual obesity did not influence the incidence of postoperative complications in postbariatric patients after plastic surgery. Keywords Bariatric surgery . Plastic surgery . Abdominoplasty . Wound dehiscence . Body-contouring surgery . Postoperative complications
Introduction A common sequela of successful weight loss after bariatric surgery that remains stigmatized is excess skin and soft tissues. Body-contouring plastic surgery promotes social and psychological reintegration for these patients. In addition, plastic surgery procedures after gastric bypass aim to optimize the functional results obtained by bariatric surgery by removing excess skin [1]. However, these postbariatric patients often
* Jefferson Lessa Soares de Macedo [email protected] 1
Department of Plastic and Reconstructive Surgery, Asa Norte Regional Hospital, SQS 213 Bloco H Apto 303. Asa Sul, CEP, Brasília, DF 70 292-080, Brazil
2
Post-Graduation Course in Health Sciences, University of Brasília, Brasília, DF, Brazil
3
Superior School of Health Sciences/FEPECS, Brasília, DF, Brazil
present to plastic surgeons with residual medical comorbidities, which causes this group of patients to be at risk for postoperative complications. Complications in wound healing are common after body-contouring surgery in postbariatric patients, with studies showing rates ranging from 8 to 66%. These complications include sero
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