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Brachioplasty in the Post-bariatric Patient-A Systematic Review
Pietro Susini1, Gianluca Marcaccini2, Giuseppe Diluiso3
1Plastic Surgery Unit, Department of Medicine, Surgery and Neuroscience, University of Siena, Policlinico le Scotte, Via Bracci 16, 53100, Siena, Italy. susinipietro@gmail.com.
Background:
Arm remodeling surgery is becoming increasingly popular due to the high impact of this anatomical unit in terms of life relationships, non-verbal language, and aesthetic concern. When referring to the post-bariatric brachioplasty (PBB), plenty of techniques have been proposed. However, PBB is challenging due to technical factors and patient's comorbidities, the evidence is limited, and there is a debate on the appropriate treatment choice. The present paper, through a systematic review, introduces a new classification system for PBB procedures, aiming to improve the management of post-bariatric patients.
Methods:
A systematic review was carried according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement by searching the PubMed (MEDLINE) database from December 2004 to December 2024 using the keywords ''brachioplasty OR arm contouring OR postbariatric brachioplasty OR (arm contouring AND weight loss) OR (arm contouring AND liposuction)". Original studies discussing PBB with a minimum of three clinical cases were eligible for inclusion.
Results:
The final synthesis included 39 papers and 1972 patients from articles published in the last 20 years. Various PBB surgical strategies and technical measures were evidenced.
Conclusions:
The proposed classification allows a comprehensive assessment PBB techniques, possibly facilitating the treatment choice based on a patient's individual needs. Liposuction-assisted traditional PBB with the scar at the bicipital groove is effective for most post-bariatric patients. However, selected candidates may benefit from a more invasive treatment as suggested by this simple and intuitive surgical algorithm.
Level Of Evidence Iii:
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 the Table of Contents or the online Instructions to Authors www.springer.com/00266 .
