INTRODUCTION: Obesity has become a global epidemic. It has led to a gradual increase in bariatric surgery. French health authorities count more than 60000 bariatric procedures per year. The success of weight loss surgery created a growing demand for body contouring procedures. Lower body lift is an attractive option to treat the remaining excessive fat and circumferential skin laxity. This procedure is associated with a substantial rate of adverse events. The objective of this study is to evaluate the safety of the procedure and to determine the risk factors of adverse events.
METHODS: A monocentric retrospective review of all body lift procedures performed between January 2011 and January 2017 was conducted. The following data was extracted from each patient record: age, gender, body mass index (BMI), comorbidities, smoking status, previous bariatric surgery, maximum amount of weight loss, preoperative and postoperative hemoglobin level, surgical technique for buttock augmentation, hospitalization duration and postoperative complications including hematoma, seroma, the need of blood transfusion, infection, wound dehiscence, skin flap necrosis, venous thrombosis and pulmonary embolism. Multivariate analysis regarding complications was done. The outcomes were compared to current literature results.
RESULTS: 280 patients were included for analysis. The mean age was 35 years, the mean BMI was 26.9kg/m2 and sleeve gastrectomy was the most frequently performed bariatric surgery. 67.5% of patient didn’t have any complication, 22.1% had a wound dehiscence and 7.9% developed a seroma. No skin necrosis, venous thrombosis or pulmonary embolism were reported. Repeat surgery due to infection or hematoma was necessary in 8.6% of patients. Comparison of patients with complications to patients without complications found a statistically significant difference regarding the type of bariatric surgery (p=0.020). Sleeve gastrectomy was more frequently performed is patients that had a complication following the body lift (55%) compared to the patients who did not have a complication (35%). Multivariate logistic regression showed a similar result where the sleeve was associated with significantly lower odds of complications when compared to bypass (OR= 0.45, p=0.020).
CONCLUSION: Lower body lift is a key procedure in the massive weight loss patient. It is an effective surgery with a low rate of major complications when the patient selection has been made wisely.