Brachioplasty and concomitant procedures after massive weight loss: a statistical analysis from a prospective registry.
BACKGROUND
A growing number of massive weight loss patients are undergoing brachioplasty. The authors analyzed data from a prospective registry of massive weight loss patients who underwent brachioplasty alone or with concomitant operations to identify statistically significant complications.


METHODS
One hundred one massive weight loss patients underwent brachioplasty. Outcome measures included operative time; time since gastric bypass; need for revision; arm liposuction; and complications such as seroma, dehiscence, hematoma, infection, and nerve injury. Univariate analyses were performed to assess outcome measures.


RESULTS
One hundred one patients (97 women and four men; mean age, 45.9 +/- 10.1 years; mean body mass index, 29 +/- 3.9) with a mean time since gastric bypass of 28.5 months (range, 7 to 252 months) underwent brachioplasty. Ninety-seven patients (96 percent) had concomitant body contouring procedures; 23.8 percent had concomitant arm liposuction; and 36 patients had complications related to their arms, mostly in the form of a seroma, whereas dehiscence, infection, and hematoma were more prevalent with the concomitant procedures. Patients with a greater change in body mass index had a higher chance of wound infection (odds ratio, 1.1; p = 0.028). Longer operative time was associated with increased rates of surgical complications (p = 0.003; odds ratio, 3.8) at the operative site. There was a trend toward increased complications when arm liposuction was combined with brachioplasty (odds ratio, 2.5; p = 0.05).


CONCLUSIONS
Brachioplasty is a safe and effective method of treating upper arm deformity in the massive weight loss patient. Although patients with greater weight loss are likely to present for longer contouring procedures and are at highest risk for wound-healing complications, these complications occur most frequently in areas other than the arms.
Gusenoff
Jeffrey A
JA
Pittsburgh, Pa. From the Division of Plastic and Reconstructive Surgery, University of Pittsburgh Medical Center, and the Life After Weight Loss Center.
Coon
Devin
D
Rubin
J Peter
JP
D000328:Adult; D001132:Arm / Q000601:surgery*; D015992:Body Mass Index; D002921:Cicatrix / Q000601:surgery; D003131:Combined Modality Therapy; D003430:Cross-Sectional Studies; D062109:Dermatologic Surgical Procedures; D015444:Exercise; D005260:Female; D015390:Gastric Bypass; D015391:Gastroplasty; D006801:Humans; D015187:Lipectomy; D008297:Male; D016462:Mammaplasty; D008875:Middle Aged; D016017:Odds Ratio; D011183:Postoperative Complications / Q000453:epidemiology / Q000209:etiology / Q000601:surgery*; D011446:Prospective Studies; D019651:Plastic Surgery Procedures / Q000379:methods*; D012042:Registries; D012086:Reoperation; D012307:Risk Factors; D013530:Surgical Wound Infection / Q000209:etiology; D015431:Weight Loss / Q000502:physiology*