title: Incidence and Risk Factors of Major Complications in Brachioplasty: Analysis of 2,294 Patients.
abstract: BACKGROUND
  Brachioplasty is a popular procedure to correct upper arm ptosis. However, current literature on complications and risk factors is scant and inconclusive.
  
  
  OBJECTIVE
  Using a large, prospective, multicenter database, we report the incidence of major complications and risk factors in patients undergoing brachioplasty.
  
  
  METHODS
  Patients who underwent brachioplasty between 2008 and 2013 were identified from the CosmetAssure (Birmingham, AL) database. The primary outcome was the occurrence of major complication(s), defined as complications requiring emergency room visit, hospital admission, or reoperation within 30 days of the procedure. Risk factors including age, gender, body mass index (BMI), smoking, diabetes, combined procedures, and type of surgical facility were evaluated using univariate and multivariate analysis.
  
  
  RESULTS
  Within the 129,007 patients enrolled in CosmetAssure, 2294 (1.8%) underwent brachioplasty. Brachioplasty patients were more likely to be older than 50 years (50.1%), obese (36.3%), diabetic (5.5%), but less likely smokers (5.5%). Major complications occurred in 3.4% brachioplasties with infection (1.7%) and hematoma (1.1%) being most common. Combined procedures, performed in 66.8% cases, had a complication rate of 4.4%, in comparison to 1.3% for brachioplasties performed alone. Combined procedures (RR = 3.58), males (RR = 3.44), and BMI ≥ 30 kg/m(2) (RR = 1.92) were identified as independent risk factors for the occurrence of any complication. Combined procedures (RR = 12.42), and the male gender (RR = 8.89) increased the risk of hematoma formation.
  
  
  CONCLUSIONS
  Complication rates from brachioplasty are much lower than previously reported. Hematoma and infection are the most common major complications. Combined procedures, male gender, and BMI ≥ 30 kg/m(2) are independent risk factors for complications. LEVEL OF EVIDENCE 2: Risk.
authors.affiliation: Drs Nguyen and Afshari are Plastic Surgery Research Fellows, Drs Gupta and Higdon are Assistant Professors, and Dr Shack is the Chair, Department of Plastic Surgery, Vanderbilt University, Nashville, TN. Dr Afshari is also a General Surgery Resident, Department of General Surgery, University of South Carolina, Columbia, SC. Dr Grotting is a Clinical Professor, Division of Plastic Surgery, University of Alabama at Birmingham, Birmingham, AL; and CME/MOC Section Editor for Aesthetic Surgery Journal.
authors.forename: Lyly
authors.initials: L
authors.lastname: Nguyen
authors.affiliation: Drs Nguyen and Afshari are Plastic Surgery Research Fellows, Drs Gupta and Higdon are Assistant Professors, and Dr Shack is the Chair, Department of Plastic Surgery, Vanderbilt University, Nashville, TN. Dr Afshari is also a General Surgery Resident, Department of General Surgery, University of South Carolina, Columbia, SC. Dr Grotting is a Clinical Professor, Division of Plastic Surgery, University of Alabama at Birmingham, Birmingham, AL; and CME/MOC Section Editor for Aesthetic Surgery Journal.
authors.forename: Varun
authors.initials: V
authors.lastname: Gupta
authors.affiliation: Drs Nguyen and Afshari are Plastic Surgery Research Fellows, Drs Gupta and Higdon are Assistant Professors, and Dr Shack is the Chair, Department of Plastic Surgery, Vanderbilt University, Nashville, TN. Dr Afshari is also a General Surgery Resident, Department of General Surgery, University of South Carolina, Columbia, SC. Dr Grotting is a Clinical Professor, Division of Plastic Surgery, University of Alabama at Birmingham, Birmingham, AL; and CME/MOC Section Editor for Aesthetic Surgery Journal.
authors.forename: Ashkan
authors.initials: A
authors.lastname: Afshari
authors.affiliation: Drs Nguyen and Afshari are Plastic Surgery Research Fellows, Drs Gupta and Higdon are Assistant Professors, and Dr Shack is the Chair, Department of Plastic Surgery, Vanderbilt University, Nashville, TN. Dr Afshari is also a General Surgery Resident, Department of General Surgery, University of South Carolina, Columbia, SC. Dr Grotting is a Clinical Professor, Division of Plastic Surgery, University of Alabama at Birmingham, Birmingham, AL; and CME/MOC Section Editor for Aesthetic Surgery Journal.
authors.forename: R Bruce
authors.initials: RB
authors.lastname: Shack
authors.affiliation: Drs Nguyen and Afshari are Plastic Surgery Research Fellows, Drs Gupta and Higdon are Assistant Professors, and Dr Shack is the Chair, Department of Plastic Surgery, Vanderbilt University, Nashville, TN. Dr Afshari is also a General Surgery Resident, Department of General Surgery, University of South Carolina, Columbia, SC. Dr Grotting is a Clinical Professor, Division of Plastic Surgery, University of Alabama at Birmingham, Birmingham, AL; and CME/MOC Section Editor for Aesthetic Surgery Journal.
authors.forename: James C
authors.initials: JC
authors.lastname: Grotting
authors.affiliation: Drs Nguyen and Afshari are Plastic Surgery Research Fellows, Drs Gupta and Higdon are Assistant Professors, and Dr Shack is the Chair, Department of Plastic Surgery, Vanderbilt University, Nashville, TN. Dr Afshari is also a General Surgery Resident, Department of General Surgery, University of South Carolina, Columbia, SC. Dr Grotting is a Clinical Professor, Division of Plastic Surgery, University of Alabama at Birmingham, Birmingham, AL; and CME/MOC Section Editor for Aesthetic Surgery Journal.
authors.forename: K Kye
authors.initials: KK
authors.lastname: Higdon
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001132:Arm / Q000601:surgery*; D015992:Body Mass Index; D002648:Child; D002675:Child, Preschool; D016208:Databases, Factual; D062109:Dermatologic Surgical Procedures / Q000009:adverse effects* / Q000379:methods*; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology*; D011446:Prospective Studies; D012307:Risk Factors; D012737:Sex Factors; D055815:Young Adult