Gunnarsson Gudjon Leifur, Gudjonsdottir Linda Regina, Koidil Amelia, Haukeland Lars, Berg Erik, Thomsen Jorn Bo
From the Department of Plastic Surgery, Arendal Hospital Trust, Arendal, Norway.
Department of Medicine, University of Copenhagen, Copenhagen, Denmark.
Plast Reconstr Surg Glob Open. 2024 Oct 29;12(10):e6251. doi: 10.1097/GOX.0000000000006251. eCollection 2024 Oct.
The topographic anatomical changes of the upper arms and axilla after massive weight loss (MWL) seem ill-described in the literature. The importance of the axilla in MWL brachioplasty and how the procedure differs from the postmenopausal "batwing" deformity of the upper arms is also unclear. Consideration of the underlying pathology seems imperative for a successful reconstruction. We aim to test a procedure specifically designed to mend the underlying pathology of obesity and MWL, liposuction-assisted axillobrachioplasty (LAAB).
A prospective pilot study was designed to test the effect of LAAB on the axilla and evaluate the results comparative to patient's preoperative complaints and well-being and allow for adjustments for future trials. We measured the diameter of the arm and axilla at three specific points, A, B and C, and applied the arm module of BODY-Q regarding body perception and psychosocial well-being.
Fifteen women, for a total of 30 arms, were included. Age average was 48 years (29-59) and showed a significant improvement in all measurements A-C, most significantly at point A in the axilla, where the reduction was associated with relief of preoperative ailments and great improvement on BODY-Q ratings. The procedure was uncomplicated, with high patient satisfaction.
LAAB significantly improves the axilla and upper arm contour after MWL and correlates strongly with improvement of preoperative ailments. The study furthermore supports the clinical relevance of a posterior arm fat pad. The presented procedure seems to be uncomplicated and reproducible with a high patient satisfaction warranting a long-term clinical trial.
大量体重减轻（MWL）后上臂和腋窝的局部解剖学变化在文献中似乎描述不足。腋窝在MWL臂成形术中的重要性以及该手术与绝经后上臂“蝙蝠翼”畸形的差异也尚不清楚。考虑潜在病理对于成功重建似乎至关重要。我们旨在测试一种专门设计用于修复肥胖和MWL潜在病理的手术，即吸脂辅助腋窝臂成形术（LAAB）。
设计了一项前瞻性试点研究，以测试LAAB对腋窝的效果，并与患者术前的主诉和健康状况进行比较评估结果，以便为未来试验进行调整。我们在三个特定点A、B和C测量了手臂和腋窝的直径，并应用了关于身体感知和心理社会健康状况的BODY-Q手臂模块。
纳入了15名女性，共30只手臂。平均年龄为48岁（29 - 59岁）。所有测量点A - C均有显著改善，最显著的是腋窝的A点，此处的减小与术前疾病的缓解以及BODY-Q评分的大幅提高相关。该手术操作简单，患者满意度高。
LAAB显著改善了MWL后的腋窝和上臂轮廓，并且与术前疾病的改善密切相关。该研究进一步支持了上臂后脂肪垫的临床相关性。所提出的手术似乎操作简单且可重复，患者满意度高，值得进行长期临床试验。
