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Published on: November 10, 2018
Factors associated with resection weight and complications after massive-weight-loss abdominoplasty: A retrospective
Sabrina Luettschwager1,2, Patrick Mandal1, Lars-Peter Kamolz1,2,3,4,5
1Division of Plastic, Aesthetic and Reconstructive Surgery, Department of Surgery, Medical University of Graz, Graz, Austria.
Background:
Abdominoplasty removes redundant skin and subcutaneous tissue but poses perioperative challenges. Although higher resection weight has been linked to complications, variation in resection burden and its relationship to post-operative complications remain incompletely defined. This exploratory study assessed patient- and procedure-related factors associated with resection weight and evaluated whether resection weight was associated with post-operative complications.
Methods:
This retrospective cohort included 217 adults undergoing abdominoplasty after massive weight loss (MWL; excess weight loss ≥ 50%) at the Medical University of Graz (2012-2023). Pregnancy-related and oncologic procedures, isolated revisions, and incomplete records were excluded. Variables included weight history, resection weight, post-operative complications (Clavien-Dindo), demographics, and procedure-related factors. Correlation, group comparison, multivariable linear and logistic regression analyses were applied.
Results:
Mean age was 45 years (SD 12); 76% were female. Mean pre-operative BMI was 26.3 kg/m2 (SD 3.5) and mean resection weight was 1,727 g (SD 1,132). Pre-operative BMI showed the strongest bivariate association with resection weight (Spearman r = 0.620, p < 0.001). In multivariable linear regression, pre-operative BMI (B = 209.9 g per kg/m², p < 0.001), female sex (+363.5 g, p = 0.004), metabolic disease (+346.0 g, p = 0.006), and concomitant belt lipectomy (+365.6 g, p < 0.001) were associated with higher resection weight, explaining 56% of variance. Post-operative complications occurred in 76 patients (35.0%). In adjusted logistic regression, younger age (OR 0.969 per year, p = 0.016) and pre-operative anemia (OR 2.153, p = 0.043) were associated with the composite complication endpoint; resection weight was not (OR 1.015 per 100 g, p = 0.245).
Conclusion:
Pre-operative BMI was the strongest factor associated with resection weight, with female sex, metabolic disease, and procedural extent adding explanatory value. Resection weight was not significantly associated with composite, major, or wound-specific complications; however, smaller effects could not be excluded.
