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Post-Bariatric Abdominoplasty: Analysis of 406 Cases With Focus on Risk Factors and Complications
Torsten Schlosshauer1, Marcus Kiehlmann1, Diana Jung1
1Dr Schlosshauer is a Consultant Plastic Surgeon, Dr Kiehlmann is a plastic surgery resident, Ms Jung is a postgraduate student, and Dr Rieger is the Head of the Department, Department of Plastic and Aesthetic, Reconstructive and Hand Surgery, Agaplesion Markus Hospital, Frankfurt am Main, Germany.
Background:
Post-bariatric patients present a surgical challenge within abdominoplasty because of residual obesity and major comorbidities. In this study, we analyzed complications following abdominoplasty in post-bariatric patients and evaluated potential risk factors associated with these complications.
Objectives:
The authors sought to determine the complications and risk factors following abdominoplasty in post-bariatric patients.
Methods:
A retrospective study of patients who underwent abdominoplasty was performed from January 2009 to December 2018 at our institution. Variables analyzed were sex, age, body mass index (BMI), smoking, surgical technique, operative time, resection weight, drain output, and complications.
Results:
A total of 406 patients were included in this study (320 female and 86 male) with a mean age of 44.4 years and a BMI of 30.6 kg/m2. Abdominoplasty techniques consisted of traditional (64.3%), fleur-de-lis technique (27.3%), and panniculectomy without umbilical displacement (8.4%). Overall complications recorded were 41.9%, the majority of these being wound-healing problems (32%). Minor and major complications were found in 29.1% and 12.8% of patients, respectively. A BMI value of ≥30 kg/m2 was associated with an increased risk for wound-healing problems (P = 0.001). The frequency of total complications was significantly related to age (P = 0.007), BMI (P = 0.004), and resection weight (P = 0.001). Abdominoplasty technique tended to influence total complications.
Conclusions:
This study demonstrates in a fairly large sample of post-bariatric patients (n = 406) that abdominoplasty alone can be performed safely, with an acceptable complication rate. Age, BMI, and resection weight are shown to be significant risk factors for total complications. The role of surgical technique needs to be evaluated further.
Abstract:
Level of Evidence: 4.
