Reconstructive procedures after massive weight loss

Following excess weight loss in many patients, a dermolipectomy of the abdomen, arms and thighs becomes necessary. This kind of operation was offered to 88 former morbidly obese patients after having lost between 50% and 75% of their excess weight.

Abdomen: Because of a distinct pannus, a dermolipectomy was performed in 66 females and 16 males. An average of 2800+/-1381 g of tissue was removed from the females and 3116+/-2195 g from the males. Operative time was 166+/-35 and 177+/-46 minutes for the female and male patients, respectively. Minor and major wound healing disorders occurred in 23% and 19% of the patients. In two females, a panniculectomy (12.4/13.5 kg) was performed after they had reached 150 kg of body weight. Thighs: A medial thigh lift was performed in 19 females (excision of varicose veins was included in 9 patients). In patients receiving a dermolipectomy only, 1212 g of tissue was removed in 172+/-81 minutes. Five patients had complications (wound infection, lymphatic fistula). With both dermolipectomy and varicectomy, 1358 g of tissue were removed in 294+/-80 minutes. Four patients developed a wound infection. Arms: 7 female patients had brachioplasty performed, with an average of 410 g of tissue removed from both arms over a period of 161+/-64 minutes. In one patient, a neurolysis of the ulnar nerve became necessary due to postoperative edema.

Dermolipectomy and/or panniculectomy should be offered to bariatric patients who have lost massive amounts of weight.