title: Abdominal contouring in super obese patients: a single-surgeon review of 22 cases.
abstract: BACKGROUND
  It is generally believed that increasing obesity is a predictor of postoperative complications after abdominal contouring procedures such as abdominoplasty and panniculectomy. The purpose of this study is to review the complication rate for abdominal contouring in the level 3 obesity category (body mass index [BMI], >40 kg/m2) and to examine the safety of this procedure when performed in this select patient population.
  
  
  METHODS
  Between 2003 and 2008, an institutional review board-approved, single-surgeon, single-institution retrospective review was conducted for all patients presenting for abdominal contouring. In all, 100 patients with precontouring BMI <40 kg/m2 were excluded, resulting in 22 patients who met the criteria for Level 3 obesity category, which are also referred as "super obese." To date, this is the largest series that has reported pertaining to this category and procedures.
  
  
  RESULTS
  In this series, 77% (17/22) had prior bariatric surgery. The mean hospitalization was 2.8 days and mean length of follow-up was 202 days. The major complication rate was 4.5% (1/22).
  
  
  CONCLUSIONS
  Abdominal contouring can be performed safely, effectively, and with minimal morbidity in the super obese. Only one patient required readmission after developing an infected seroma and all patients progressed to a well-healed wound. BMI >40 kg/m2 should not preclude patients from undergoing this functional and beneficial surgical procedure.
authors.affiliation: Department of Plastic Surgery, University of Virginia, Charlottesville, VA, USA.
authors.forename: Alexander F
authors.initials: AF
authors.lastname: Mericli
authors.forename: David B
authors.initials: DB
authors.lastname: Drake
mesh_terms: D000328:Adult; D050110:Bariatric Surgery / Q000009:adverse effects / Q000379:methods*; D015992:Body Mass Index; D015331:Cohort Studies; D004954:Esthetics; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009767:Obesity, Morbid / Q000175:diagnosis / Q000601:surgery*; D017060:Patient Satisfaction; D011183:Postoperative Complications / Q000503:physiopathology / Q000601:surgery; D019651:Plastic Surgery Procedures / Q000009:adverse effects / Q000379:methods*; D012189:Retrospective Studies; D018570:Risk Assessment; D050507:Subcutaneous Fat, Abdominal / Q000601:surgery*; D016896:Treatment Outcome