[The effect of body mass index on outcome of body contouring surgeries]

BACKGROUND

The generalization of bariatric surgery interventions has led in recent years to an explosion in demand for body contouring surgeries. These operations can be followed by postoperative complications; and residual obesity, defined by a BMI≥30, is traditionally considered as a relative contraindication. The objective is to study the influence of a BMI≥30 on the risk of postoperative complications.

METHODS

A retrospective study was conducted on all patients who underwent body contouring surgery between 2014 and 2020 at the Arras Hospital Center. Major complication rates were compared in obese and non-obese patients.

RESULTS

Two hundred twenty-three patients were included, representing a total of 247 surgeries: 124 in the BMI<30 group and 123 in the BMI≥30 group. Sixteen surgeries were followed by at least one major complication, 6 in group I versus 10 in group II (RR=1.7 (0.6-4.5), NS, P=0.29). Therefore there were not significantly more major complications in obese patients.

CONCLUSION

The incidence of major complications following body contouring surgeries is not modified by the presence of a BMI greater than 30, subject to a precautionary procedure adapted to each patient. BMI is therefore not a sufficient criterion to contraindicate this type of surgery.

[Management of weight loss consequences in the male chest: The amputation grafting technique with a L scar]

INTRODUCTION

Following the upsurge in cases of morbid obesity and bariatric surgery, there is after massive weight loss effects of the thorax in man such as pseudogynecomastia extremely poorly tolerated by patients. Treatment aims to correct the excess skin while optimizing the location and quality of scars. Turning our back on techniques derived from mammoplasty, we go into these major forms for mastectomy with grafting the areolo-mammelonar plate and resulting scar in L extended if needed until the axilla.

MATERIALS AND METHODS

From 2005 to 2011, we performed 12 mastectomies after massive weight loss (45 kg on average). Patients aged 19 to 64 had an average BMI of 29.2. In five patients, we had started the move by liposuction (190 cc average per side). The mastectomy was performed by placing the scar at the lower edge of the pectoralis major. The areolas previously harvested were placed on the axis of the graft within two to three centimeters above the scar. All patients were reviewed and evaluated in consultation questionnaire with an average follow up of 2 years (6 months-5 years).

RESULTS

The average volume of resection was 560 g per side (55 g-2500 g), operative time 155 minutes. Complications consisted of hematoma requiring surgical revision and delayed wound healing in three over 1 month with partial areola necrosis. The overall patient satisfaction was excellent with no secondary correction request.

CONCLUSION

In the major pseudogynecomastia, the option is taken immediately for a mastectomy technique which scar is located at the basis of the thorax and may include an axillary extension in L. It effectively corrects the large cutaneous and fat surplus and restores in one time a flat male chest. Satisfaction is high and patients are no more ashamed to expose their chest.