The development of sophisticated bariatric surgery techniques has led to an increasing number of patients demanding a complexity of body contouring procedures that can be achieved either with a step-by-step approach or by combining dermolipectomy in various regions. The aim of this study was to test the hypothesis that abdominoplasty-related morbidity and outcome may be worsened by combining abdominoplasty with other dermolipectomies and to determine whether any predictive risk factor could be identified. Seventy-three consecutive patients undergoing abdominoplasty with (n = 26) and without (n = 47) additional dermolipectomy on the upper arms, inner thighs, breasts, and buttocks were included in this study. Additional dermolipectomies did not increase abdominoplasty-related morbidity but revealed better long-term results (p = 0.10). Statistically significant risk factors were male sex, age (>41 years), overweight (BMI > 30), prolonged operations (>3 hours), and extensive blood loss (1,000 mL). Most importantly, better outcome was obtained in patients whose weight reduction was greater (p = 0.04). The authors’ results suggest that combined dermolipectomy procedures can be advocated in patients who have reached their intended level of weight reduction and if prolonged operative time and excessive blood loss are avoided.
Seventy-three consecutive abdominoplasties were performed with (n = 26) and without (n = 47) additional dermolipectomy in remote sites. Although the complication rate was 59% (primarily wound problems), additional dermolipectomies did not increase abdominoplasty-related morbidity but resulted instead in better long-term results.
From the Division of Plastic Surgery, Inselspital University Hospital, Berne, Switzerland.
Received Oct 28, 2002, and
in revised form Feb 23, 2003.
Accepted for publication Feb 23, 2003.
Reprints: Dr D. Erni, Division of Plastic Surgery, Inselspital, University Hospital Berne, CH-3010 Berne, Switzerland; E-mail: email@example.com