ABSTRACT
BACKGROUND: Breast reduction surgery is a widely performed plastic surgery procedure. The incidence of such complications has been steadily decreasing in recent years but is still nonetheless 5.6%. The primary aim of this study was to analyze the incidence of the main postoperative complications of breast reduction surgery. In addition, we identified cause-and-effect links between complications and characteristics of the patients, such as smoking, age, weight resection, BMI, and wound drainage. MATERIALS AND METHODS: This retrospective study was performed on a population of 1442 women who underwent breast reduction surgery between January 2016 and October 2022 in the plastic surgery unit at Saint-Louis Hospital, Paris, France. At the follow-up examination, we evaluated the patients for complications. RESULTS: The average resection weight was 1297.7 g in a population for which the average BMI was 28.9. We found 19.9% rate of total complications, of which 3.5% were major complications. We found that only the resection weight was a risk factor for complications. DISCUSSION: The main strength of our study is the size of our sample. The large number of patients allowed us to conduct numerous analyses and obtain significant results despite the rarity of certain events. This large cohort was also responsible for the high statistical power of our results. CONCLUSION: The risk of developing a postoperative infection was 7.5% for resections of less than 2.4 kg, increasing to 13.9 % when greater than that. Thus, the administration of prophylactic antibiotic therapy to affected women to reduce the risk of infection is a distinct consideration. For the other factors, while none of them appeared to promote the occurrence of adverse events and, therefore, do not formally contraindicate breast reduction surgery, some preventive measures still strike us as being relevant, such as blade drainage, weight loss, diabetes control, and smoking cessation. 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 .
ABSTRACT
BACKGROUND: Despite its rarity, cutaneous adipose tissue excess in the trochanteric region following massive weight loss is a surgical challenge. The aim of this work is to propose a surgical technique for lifting the outer thighs by describing its indications and its limitations. METHODS: 74 patients were recruited into the study between 2018 2021. Two groups were identified: patients with bodylift combined with lateral thigh lift (n=20) and patients with lower bodylift (n=54). Satisfaction was obtained through the BODY Q questionnaire. The average operating time is 45 minutes longer when an outer thigh lift is performed. The median length of hospitalization is similar. The complication rate is 26% for the bodylift group and 60% for the thigh lift group (p<0.01); the most common complication is dehiscence. RESULTS: Data analysis shows that the lateral thigh lift technique does not affect immediate postoperative evolution or hospitalization duration, proving its safety. There was an increase in total complications among patients who underwent lateral thigh lifts. Dehiscence is the most common complication, which is an outpatient treatment. The satisfaction rate is high. Satisfaction is linked to improved quality of life. CONCLUSIONS: In our experience, the technique described is an effective means of trochanteric deformities.
ABSTRACT
BACKGROUND: Patients with massive weight loss have excessive skin laxity along both vertical and transverse axes. Vertical body lift (VBL) is a body-contouring technique addressing both excesses, promoting not only body lifting but also a tightening effect. The aim of this study was to describe the authors' VBL surgical technique and its potential clinical applications. In addition, they present their experience among postbariatric surgery patients to compare surgical aspects and outcomes of VBL and the classic inferior body lift (IBL) technique. METHODS: The authors reviewed data on 140 consecutive postbariatric surgery patients who underwent a body lift procedure between January of 2018 and March of 2020. The patients were divided into two groups: the VBL group and the IBL group. Patient demographics, operative details, and postoperative outcomes were compared between groups. RESULTS: Of the 140 patients included in the study, 92 underwent IBL and 48 underwent VBL. There were no statistically significant differences between groups for surgical duration (IBL, 192 minutes; VBL, 193 minutes), hemoglobin decrease (IBL, 2.32 g/dL; VBL, 2.11 g/dL), hospital length of stay (IBL, 5.4 days; VBL, 5.7 days), or complication rate (IBL, 32%; VBL, 31%). CONCLUSIONS: The authors' study shows comparable operative details and postsurgical outcomes between the VBL and classic IBL techniques. In their experience, VBL is a reliable and reproducible technique that can improve aesthetic and functional outcomes in a subpopulation of approximately one-third of patients with massive weight loss. CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, III.
