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How To Reduce Thighplasty Complications Using the Boomerang Technique

Garcia, Elvio Bueno MD, PhD; Gurgel, Augusto MD; Sallum, Natasha MD; Pedroso, Juan Carlos Montano MD; Tedesco, Ana Carolina Bim PT; Takassi, Guilherme MD; Arrudal, Lilia Cristina PT; Ota, Ana Carolina Sayuri MD; Ferreira, Lydia Masako MD, PhD

Plastic and Reconstructive Surgery: October 2013 - Volume 132 - Issue 4S-1 - p 162-163
doi: 10.1097/01.prs.0000436047.08135.90
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INTRODUCTION: Patients who undergo bariatric surgery represent an increased demand for plastic surgeons.1,2,3 After massive weigh loss, skin ptosis observed on the thighs is a frequent complaint.1,4,5 In order to reduce the reported incidence of complications, this study describes a thighplasty technique with a boomerang-like resection that decreases suture tension. Complications and satisfaction are reported in a case series.

METHODS: 16 patients with massive weight loss after bariatric surgery underwent the Boomerang thighplasty, between March 2011 and August 2012. Skin Markings: On standing position with lower limbs rotated laterally, a median line on the medial thigh and a line parallel to the groin crease were drawn. Skin laxity is evaluated by pinch test and an anterior and diagonal line was marked. A line dividing the posterior angle (bisectrix) was marked. A semi-circle is drawn and its radius was one third the distance of the bisectrix (Figure 1). In supine position, lower limbs abducted and knees bent, the marked excess skin and subcutaneous were resected preserving deep fascia and great saphenous vein. The flap was not attached to the Colle’s fascia. Suction drains were placed. A satisfaction questionnaire was answered on the 6th month post-op with 10 questions related to scar, edema, symmetry, sensibility, contour, lighter thigh perception, mobility, agility, ease in getting dressed and final cosmetic result.

Figure 1
Figure 1:
Skin markings.

RESULTS: No dehiscence, hematoma or infection in a 1 year follow-up (Figure 2). One patient presented seroma and was aspirated with adequate outcome. Satisfaction reached 86% (average grade 25,8 from a total of 30 points).

Figure 2
Figure 2:
1 month post-op medial view.

CONCLUSION: The Boomerang Thighplasty appeared to be reproducible with decreased complication data and elevated satisfaction for post-bariatric patients.

REFERENCES:

1. Shermak MA, Mallalieu J, Chang D. Does thighplasty for upper thigh laxity after massive weight loss require a vertical incision? Aesthet Surg J. 2009;29:513–522
2. Mathes DW, Kenkel JM. Current concepts in medial thighplasty. Clin Plast Surg. 2008;35:151–163
3. Montano–Pedroso JC, Garcia EB, Omonte IR, et al. Hematological variables and iron status in abdominoplasty after bariatric surgery. Obes Surg. 2013;1:7–16
4. Hurwitz D. Medial thighplasty. Aesthetic Surg J. 2005;25:180–191
5. Kenkel JM, Eaves FF. Medial thight lift. Plast Reconstr Surg. 2008;35:73–91
©2013American Society of Plastic Surgeons