title: Limb contouring after massive weight loss: functional rather than aesthetic improvement.
abstract: BACKGROUND
  After massive weight loss, both upper and lower limbs show a similar deformity which consists of redundancy and ptosis of the cutaneous mantle. Many disturbances are associated with this abnormality, which can be treated surgically. A retrospective review of limb-contouring procedures after massive weight loss is presented.
  
  
  METHODS
  Thigh lift and arm lift procedures are described. All surgeries of upper and lower limbs contouring performed between 2003 and 2006 are reviewed with regard to quantity of tissue removed, comorbidities, complications and patients' satisfaction, which was surveyed through a questionnaire exploring functional and esthetic results (maximum score 3).
  
  
  RESULTS
  Among 48 bilateral limb-contouring procedures, medial thigh lifts were 35 (73%) and brachioplasties were 13 (27%). Mean age was 46 and average body mass index variation was 20 kg/m(2). The most frequent comorbidity was gallstones (28%). In 46% of the whole group of patients, there was no complication to mention. The most frequent complication was acute anaemia in both procedures (43% in thigh lift and 54% in arm lift). Mean quantity of adipose-dermoid tissue removed was 766 g in thigh lift and 463 g in arm lift. In case of surgery combined with liposuction, the average aspirated volume was 1,933 ml (thighs) and 1,117 ml (arms). Patients' satisfaction was 2.7 for thighs and 2.6 for arms, as average.
  
  
  CONCLUSIONS
  The rate of complications in limb contouring after weight loss is higher than the analogue esthetic procedures. Nevertheless, due to the rehabilitative significance of limb surgery after weight loss, this step is to be included as fundamental in obese patients' surgical therapy.
authors.affiliation: Department of Plastic, Reconstructive and Aesthetic Surgery, University of Turin, Turin, Italy.
authors.forename: S
authors.initials: S
authors.lastname: Bruschi
authors.forename: G
authors.initials: G
authors.lastname: Datta
authors.forename: M A
authors.initials: MA
authors.lastname: Bocchiotti
authors.forename: F
authors.initials: F
authors.lastname: Boriani
authors.forename: F D
authors.initials: FD
authors.lastname: Obbialero
authors.forename: M
authors.initials: M
authors.lastname: Fraccalvieri
mesh_terms: D000328:Adult; D000368:Aged; D001132:Arm / Q000601:surgery; D015897:Comorbidity; D005260:Female; D006801:Humans; D015187:Lipectomy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009767:Obesity, Morbid / Q000453:epidemiology / Q000601:surgery; D017060:Patient Satisfaction; D011184:Postoperative Period; D019651:Plastic Surgery Procedures / Q000379:methods; D012189:Retrospective Studies; D040521:Subcutaneous Tissue / Q000601:surgery; D013848:Thigh / Q000601:surgery; D015431:Weight Loss / Q000502:physiology