title: Circular abdominoplasty after massive weight loss: Is it a risky procedure?
abstract: BACKGROUND
  Most post-bariatric patients seek body contouring procedures to correct skin excess after massive weight loss. Among these procedures, some surgeons are still wary of circular abdominoplasty, mainly because it is considered a major intervention associated with a high complication rate. The aim of this study was to assess the complication rate of circular abdominoplasty performed on patients presenting with massive weight loss, with a particular emphasis on patient selection and surgical technique.
  
  
  METHODS
  Fifty-six consecutive patients who underwent circular abdominoplasty following massive weight loss between January 2001 and March 2015 were included in the study. The indications for the procedure were abdominal skin excess extending to the flanks and the posterior region of the lower trunk. Data were collected retrospectively through medical charts and photographs.
  
  
  RESULTS
  Forty-nine patients were female. The mean age was 39.8 years, with a mean preoperative body mass index of 25.7 kg/m2. The mean time between bariatric surgery and circular abdominoplasty was 3.3 years. The overall complication rate was 23.2%, mostly minor, with only one (1.7%) early surgical revision under local anesthesia for delayed wound healing. Blood transfusion was required for 8.9% of patients.
  
  
  CONCLUSIONS
  Patient selection (e.g., body mass index < 30 kg/m2), precise preoperative planning and markings, and simple and careful surgical technique with minimal liposuction and undermining are crucial. Ensuring these key factors renders circular abdominoplasty a reliable and safe procedure, with low complication rates.
authors.affiliation: Division of Plastic, Reconstructive and Aesthetic Surgery, Geneva University Hospitals, University of Geneva, Faculty of Medicine, Geneva, Switzerland. Electronic address: ali.modarressi@hcuge.ch.
authors.forename: Ali
authors.initials: A
authors.lastname: Modarressi
authors.affiliation: Division of Plastic, Reconstructive and Aesthetic Surgery, Geneva University Hospitals, University of Geneva, Faculty of Medicine, Geneva, Switzerland.
authors.forename: Eva
authors.initials: E
authors.lastname: Meia Rüegg
authors.affiliation: Division of Plastic, Reconstructive and Aesthetic Surgery, Geneva University Hospitals, University of Geneva, Faculty of Medicine, Geneva, Switzerland.
authors.forename: Thierry
authors.initials: T
authors.lastname: Bezzola
authors.affiliation: Division of Plastic, Reconstructive and Aesthetic Surgery, Geneva University Hospitals, University of Geneva, Faculty of Medicine, Geneva, Switzerland.
authors.forename: Brigitte
authors.initials: B
authors.lastname: Pittet-Cuénod
mesh_terms: D034861:Abdominal Wall / Q000601:surgery; D061645:Abdominoplasty / Q000009:adverse effects / Q000379:methods; D000328:Adult; D050110:Bariatric Surgery / Q000379:methods; D005260:Female; D006801:Humans; D015187:Lipectomy / Q000379:methods; D008297:Male; D017060:Patient Satisfaction; D018579:Patient Selection; D012189:Retrospective Studies; D016896:Treatment Outcome; D015431:Weight Loss
keywords: Bariatric surgery; Body contouring; Circular abdominoplasty; Circular belt lipectomy; Complication; Massive weight loss