title: Modified circumferential torsoplasty for the massive-weight-loss patient.
abstract: BACKGROUND
  Obesity is an increasing national public health issue that has reached epidemic proportions over the past several decades. With new surgical advances in bariatric surgery, the massive-weight-loss patient population is on the rise. The generalized redundancy of skin following massive weight-loss, including lateral flank rolls, abdominal excesses, and buttock ptosis, is a problem amenable only by surgical excision. The circumferential torsoplasty has enabled the plastic surgeon to dramatically help this patient population. However, a problem exists in a size mismatch of the abdomen between the upper and lower circumferential flaps, leading to contour deformities.
  
  
  METHODS
  This study reports on 3 cases of circumferential torsoplasty, with modified lateral skin wedge resection treated by a single surgeon. The preoperative markings, technical aspects of the surgery, postoperative care, and outcomes are reviewed.
  
  
  RESULTS
  Patients in all 3 cases achieved improved body contour. To date, there have been no postoperative complications of the study participants.
  
  
  CONCLUSIONS
  We propose a new modification to the circumferential torsoplasty that simultaneously eliminates the lateral dog-ears and prevents recurrence of saddlebag deformities commonly encountered in the traditional circumferential torsoplasty. A wedge excision of lateral thigh skin to deep investing fascia is primarily closed and simultaneously equalizes flap length and tightens the thigh area. The scars are well accepted by patients.
authors: Department of Plastic Surgery, Georgetown University Medical Center, Washington, DC 20007, USA. Spd2@georgetown.edu
authors: Steven P
authors: SP
authors: Davison
authors: Mark W
authors: MW
authors: Clemens
authors: Suzie
authors: S
authors: Chang
mesh_terms: D000273:Adipose Tissue / Q000601:surgery*; D000328:Adult; D050110:Bariatric Surgery; D062109:Dermatologic Surgical Procedures; D005260:Female; D006801:Humans; D015187:Lipectomy; D009767:Obesity, Morbid / Q000601:surgery; D015431:Weight Loss