title: The effect of massive weight loss status, amount of weight loss, and method of weight loss on body contouring outcomes.
abstract: BACKGROUND
  The impact of massive weight loss (MWL) on body contouring procedures and outcomes has not been firmly established in the literature.
  
  
  OBJECTIVE
  The authors investigate the correlations between MWL status, the method of achieving MWL, and the amount of weight lost with wound-healing complications after body contouring procedures.
  
  
  METHODS
  The charts of 450 patients (124 of whom had undergone MWL) who underwent body contouring procedures including abdominoplasty, brachioplasty, thighplasty, breast mastopexy/reduction, lower bodylift, bodylift, buttock lift, and liposuction were reviewed. MWL patients were classified as having achieved weight loss through diet and exercise, gastric banding or sleeving, or gastric bypass. Postoperative complication data were collected, including cases of infection, delayed wound healing, seroma, hematoma, dehiscence, and overall wound problems. Odds ratios (OR) were estimated using 4 multivariate logistic regression models.
  
  
  RESULTS
  MWL status was a significant predictor of wound problems (OR, 2.69; P < .001). Patients with 50 to 100 lbs of weight loss did not have a significantly increased risk of wound problems (OR, 1.93; P = .085), while patients with over 100 lbs of weight loss did (OR, 3.98; P < .001). Gastric bypass (OR, 3.01; P = <.001) had a higher risk correlation than did diet and exercise (OR, 2.72, P = .023) or restrictive bariatric surgery (OR, 2.31; P = .038) as a weight loss method. Patients who lost over 100 lbs demonstrated increased risk of complications if they had gastric bypass or restrictive procedures.
  
  
  CONCLUSIONS
  MWL was a significant risk factor for wound complications in the body contouring population. Method and amount of weight loss were also significant factors in predicting complications.
authors.affiliation: Department of Plastic Surgery, University of Texas Southwestern Medical Center, Dallas, Texas.
authors.forename: Ryan S
authors.initials: RS
authors.lastname: Constantine
authors.forename: Kathryn E
authors.initials: KE
authors.lastname: Davis
authors.forename: Jeffrey M
authors.initials: JM
authors.lastname: Kenkel
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D050110:Bariatric Surgery / Q000009:adverse effects; D004038:Diet, Reducing / Q000009:adverse effects; D015444:Exercise; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016017:Odds Ratio; D019651:Plastic Surgery Procedures / Q000009:adverse effects; D012189:Retrospective Studies; D012307:Risk Factors; D016896:Treatment Outcome; D015431:Weight Loss; D014945:Wound Healing; D055815:Young Adult
keywords: abdominoplasty; body contouring; body sculpting; bodylift; complications; liposuction; malnutrition; massive weight loss; risks; wound healing