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脂肪体提升术:一种在减肥手术后有用的新型环形身体塑形技术。

The Lipo-Body Lift: A New Circumferential Body-Contouring Technique Useful after Bariatric Surgery.

作者信息

Bertheuil Nicolas, Chaput Benoit, De Runz Antoine, Girard Paul, Carloni Raphael, Watier Eric

机构信息

Rennes, Toulouse, and Nancy, France.

From the Department of Plastic, Reconstructive and Aesthetic Surgery, Hospital Sud, University of Rennes 1; INSERM U917, University of Rennes 1; SITI Laboratory, Etablissement Français du Sang Bretagne, Rennes University Hospital; STROMAlab, UMR5273 CNRS/UPS/EFS, INSERM U1031, and the Department of Plastic, Reconstructive and Aesthetic Surgery, Rangueil Hospital; and the Department of Maxillofacial, Plastic, Reconstructive and Cosmetic Surgery, Nancy University Hospital.

出版信息

Plast Reconstr Surg. 2017 Jan;139(1):38e-49e. doi: 10.1097/PRS.0000000000002926.

Abstract

BACKGROUND

After bariatric surgery, lifting of the lower body involves a contouring technique used to achieve optimal lower trunk reconstruction. The authors describe an innovative procedure applicable after massive weight loss: the lipo-body lift method. The authors describe their experience with this novel, safe procedure.

METHODS

Twenty-five abdominal body-contouring reconstructions following massive weight loss were treated by means of circumferential lipo-body lift. The authors describe the indications for the procedure and their perioperative and postoperative management.

RESULTS

The mean patient age was 39.4 years. The mean pre-body lift body mass index was 26.71 kg/m; the average weight loss before surgery was 56.6 kg, with a mean delta body mass index loss of 20.82 kg/m. The average hospital stay was 3.52 days and the drainage duration 3.56 days. No patient experienced any major complication (e.g., hematoma, thromboembolism, bleeding, skin necrosis, or a need for revision surgery to treat complications). Minor complications including wound dehiscence, wound infection, and fat necrosis were reported in 40 percent of patients. The occurrence of complications was associated with smoking status (p = 0.0280), the volume of liposuction (p = 0.0399), and the liposuction volume per unit of body mass index (p = 0.0071).

CONCLUSIONS

The authors' novel technique is less invasive than the traditional lower body-lifting method, as shown by the absence of major complications, and allows excellent conservation of connective tissue and vessels; undermining is minimal. As obesity becomes a major problem worldwide, lifting procedures that are safe and effective are important components of reconstructive strategies and should be widely offered to patients who experience massive weight loss.

CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, IV.

摘要

背景

减肥手术后,下半身提升是一种用于实现最佳下躯干重建的塑形技术。作者描述了一种适用于大量体重减轻后的创新手术:脂肪身体提升法。作者介绍了他们使用这种新颖、安全手术的经验。

方法

对25例大量体重减轻后的腹部身体塑形重建采用环形脂肪身体提升术进行治疗。作者描述了该手术的适应症及其围手术期和术后管理。

结果

患者平均年龄为39.4岁。脂肪身体提升术前平均体重指数为26.71kg/m²;手术前平均体重减轻56.6kg,平均体重指数下降20.82kg/m²。平均住院时间为3.52天,引流持续时间为3.56天。没有患者出现任何严重并发症(如血肿、血栓栓塞、出血、皮肤坏死或需要进行修复手术来治疗并发症)。40%的患者报告了轻微并发症,包括伤口裂开、伤口感染和脂肪坏死。并发症的发生与吸烟状况(p = 0.0280)、吸脂量(p = 0.0399)以及单位体重指数的吸脂量(p = 0.0071)有关。

结论

如无严重并发症所示,作者的新技术比传统的下半身提升方法侵入性更小,并能很好地保留结缔组织和血管;剥离最少。随着肥胖成为全球主要问题,安全有效的提升手术是重建策略的重要组成部分,应广泛提供给经历大量体重减轻的患者。

临床问题/证据水平:治疗性,IV级。

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