West William, Rizk Mehdi, Alford Nicholas, Khadka Monica, Docimo Salvatore, Sujka Joseph, Mhaskar Rahul, DuCoin Christopher
From the University of South Florida Morsani College of Medicine, Tampa, FL.
Department of Surgery, University of South Florida, Tampa, FL.
Ann Plast Surg. 2025 Mar 1;94(3):273-276. doi: 10.1097/SAP.0000000000004217. Epub 2025 Jan 22.
Postoperative complications in body contouring surgery have been linked to several factors, including body mass index, diabetes, cardiovascular disease, and skin resection weight. Prior weight loss by surgical means is another predisposing factor for postoperative complications following body contouring. This study aims to examine these previously identified variables, and several others, in the context of a spectrum of abdominal body contouring techniques following bariatric surgery. Our goal is to highlight that current evidence supports the notion that the prior history of bariatric surgery does not significantly impact body contouring surgery's success and its associated complications.
A retrospective cohort study including all consecutive patients (N = 198) who underwent abdominal body contouring between January 2011 and January 2022 following bariatric surgery was performed. Data collected included patient demographics, medical history, perioperative variables, and postoperative outcomes. Univariate and multivariate statistical analysis was performed.
Sixty-four (32%) patients developed a postoperative complication. In the univariate analysis, patients who developed a postoperative complication were more likely to have a mental health disorder (63% vs 44%, P = 0.015) and to have undergone abdominal surgery other than panniculectomy ( P = 0.002). They also had significantly longer median operative time (160 minutes, σ = 68.9, vs 140 minutes, σ = 72.3, P = 0.037) and longer follow-up time (99 days, σ = 471.1 vs 23 days, σ = 430.5, P < 0.001). In a multivariate logistic regression model including diabetes, hypertension, abdominoplasty type, operative time, skin excision weight, and concurrent body contouring procedure, the only significant factor in complication rate was the type of abdominal body contouring. Specifically, the traditional (odds ratio: 2.72, 95% confidence interval: 1.25-5.93) and vertical abdominoplasty (odds ratio: 5.50, 95% confidence interval: 1.17 to 25.87) techniques were more likely to lead to complications compared with panniculectomy abdominoplasty, respectively.
Previously cited risk factors such as diabetes, body mass index, and skin resection weight did not increase the chance of complications. Panniculectomy appears to be a safer option for those with a history of bariatric surgery.
身体塑形手术的术后并发症与多个因素有关，包括体重指数、糖尿病、心血管疾病和皮肤切除重量。此前通过手术方式进行的体重减轻是身体塑形术后并发症的另一个诱发因素。本研究旨在在一系列减肥手术后腹部身体塑形技术的背景下，研究这些先前确定的变量以及其他几个变量。我们的目标是强调当前证据支持以下观点：减肥手术的既往史不会显著影响身体塑形手术的成功率及其相关并发症。
进行了一项回顾性队列研究，纳入了2011年1月至2022年1月期间所有在减肥手术后连续接受腹部身体塑形的患者（N = 198）。收集的数据包括患者人口统计学信息、病史、围手术期变量和术后结果。进行了单因素和多因素统计分析。
64名（32%）患者出现了术后并发症。在单因素分析中，出现术后并发症的患者更有可能患有精神健康障碍（63%对44%，P = 0.015），并且除了腹壁成形术之外还接受过腹部手术（P = 0.002）。他们的中位手术时间也显著更长（160分钟，σ = 68.9，对140分钟，σ = 72.3，P = 0.037），随访时间也更长（99天，σ = 471.1对23天，σ = 430.5，P < 0.001）。在一个多因素逻辑回归模型中，纳入了糖尿病、高血压、腹壁成形术类型、手术时间、皮肤切除重量和同期身体塑形手术，并发症发生率的唯一显著因素是腹部身体塑形的类型。具体而言，与腹壁成形术相比，传统腹壁成形术（比值比：2.72，95%置信区间：1.25 - 5.93）和垂直腹壁成形术（比值比：5.50，95%置信区间：1.17至25.87）导致并发症的可能性分别更高。
先前引用的风险因素，如糖尿病、体重指数和皮肤切除重量，并未增加并发症的发生几率。对于有减肥手术史的患者，腹壁成形术似乎是一个更安全的选择。
