title: Are There Factors Predictive of Postoperative Complications in Circumferential Contouring of the Lower Trunk? A Meta-Analysis.
abstract: BACKGROUND
  The massive weight loss patient may require a circumferential contouring of the lower trunk.
  
  
  OBJECTIVE
  To summarize the complication rates and explore the possibility of predictive risk factors for complications.
  
  
  METHODS
  We performed a systematic review using the PubMed and Cochrane databases to identify published articles on the topic. Random effects meta-analyses and meta-regression were conducted to synthesize the data gathered.
  
  
  RESULTS
  The analysis included 28 studies and 1380 patients. All but one were retrospective cohorts or case studies. Circumferential contouring of the lower trunk resulted in 37% [95%-CI 30%; 44%] overall complications; 17% [95%-CI 12%; 24%] wound dehiscences; 4% [95%-CI 3%; 5%] skin necrosis; 5% [95%-CI 3%; 9%] infections; 3% [95%-CI 2%; 4%] hematomas; 13% [95%-CI 9%; 18%] seromas; 12% [95%-CI 7%; 21%] scar irregularities; 3% [95%-CI 2%; 5%] thromboembolism; and 5% [95%-CI 3%; 8%] revisions for complications. Lower body lift-related techniques were associated with a higher rate of overall complications than belt lipectomy-related techniques (P = .002). No difference in complication rate was shown when performing a gluteal augmentation with flap. Due to insufficient data reported in the studies, risk factors for postoperative complications could not be assessed.
  
  
  CONCLUSIONS
  The whole literature provides very low reliable information. Confusion factors could not be ruled out to explain the increased complications rate for the lower body lift compared to the belt lipectomy. This finding needs to be confirmed in randomized trials. Collaborative efforts must be made to improve the evidence level of our practices and to serve patients in an optimal way.
  
  
  METHODS
  3 Therapeutic.
authors.affiliation: Drs Carloni, Watier, and Bertheuil are Plastic and Reconstructive Surgeons, and Dr Girard is a Fellow, Department of Plastic, Reconstructive, and Aesthetic Surgery, Hospital Sud, University of Rennes, Rennes, France. Dr Naudet is a Psychiatrist and Methodologist, Department of Psychiatry, Centre Hospitalier Guillaume Régnier, Rennes, France. Dr Chaput is a Plastic and Reconstructive Surgeon, Department of Plastic, Reconstructive, and Aesthetic Surgery, Rangueil Hospital, Paul Sabatier University, Toulouse, France. Dr de Runz is a Plastic and Reconstructive Surgeon, Department of Maxillofacial, Plastic, Reconstructive, and Cosmetic Surgery, Nancy University Hospital, Nancy, France. Dr Herlin is a Plastic and Reconstructive Surgeon, Department of Plastic Surgery and Burn Surgery, Hospital Lapeyronie, Montpellier University Hospital, Montpellier, France.
authors.forename: Raphael
authors.initials: R
authors.lastname: Carloni
authors.affiliation: Drs Carloni, Watier, and Bertheuil are Plastic and Reconstructive Surgeons, and Dr Girard is a Fellow, Department of Plastic, Reconstructive, and Aesthetic Surgery, Hospital Sud, University of Rennes, Rennes, France. Dr Naudet is a Psychiatrist and Methodologist, Department of Psychiatry, Centre Hospitalier Guillaume Régnier, Rennes, France. Dr Chaput is a Plastic and Reconstructive Surgeon, Department of Plastic, Reconstructive, and Aesthetic Surgery, Rangueil Hospital, Paul Sabatier University, Toulouse, France. Dr de Runz is a Plastic and Reconstructive Surgeon, Department of Maxillofacial, Plastic, Reconstructive, and Cosmetic Surgery, Nancy University Hospital, Nancy, France. Dr Herlin is a Plastic and Reconstructive Surgeon, Department of Plastic Surgery and Burn Surgery, Hospital Lapeyronie, Montpellier University Hospital, Montpellier, France.
authors.forename: Florian
authors.initials: F
authors.lastname: Naudet
authors.affiliation: Drs Carloni, Watier, and Bertheuil are Plastic and Reconstructive Surgeons, and Dr Girard is a Fellow, Department of Plastic, Reconstructive, and Aesthetic Surgery, Hospital Sud, University of Rennes, Rennes, France. Dr Naudet is a Psychiatrist and Methodologist, Department of Psychiatry, Centre Hospitalier Guillaume Régnier, Rennes, France. Dr Chaput is a Plastic and Reconstructive Surgeon, Department of Plastic, Reconstructive, and Aesthetic Surgery, Rangueil Hospital, Paul Sabatier University, Toulouse, France. Dr de Runz is a Plastic and Reconstructive Surgeon, Department of Maxillofacial, Plastic, Reconstructive, and Cosmetic Surgery, Nancy University Hospital, Nancy, France. Dr Herlin is a Plastic and Reconstructive Surgeon, Department of Plastic Surgery and Burn Surgery, Hospital Lapeyronie, Montpellier University Hospital, Montpellier, France.
authors.forename: Benoit
authors.initials: B
authors.lastname: Chaput
authors.affiliation: Drs Carloni, Watier, and Bertheuil are Plastic and Reconstructive Surgeons, and Dr Girard is a Fellow, Department of Plastic, Reconstructive, and Aesthetic Surgery, Hospital Sud, University of Rennes, Rennes, France. Dr Naudet is a Psychiatrist and Methodologist, Department of Psychiatry, Centre Hospitalier Guillaume Régnier, Rennes, France. Dr Chaput is a Plastic and Reconstructive Surgeon, Department of Plastic, Reconstructive, and Aesthetic Surgery, Rangueil Hospital, Paul Sabatier University, Toulouse, France. Dr de Runz is a Plastic and Reconstructive Surgeon, Department of Maxillofacial, Plastic, Reconstructive, and Cosmetic Surgery, Nancy University Hospital, Nancy, France. Dr Herlin is a Plastic and Reconstructive Surgeon, Department of Plastic Surgery and Burn Surgery, Hospital Lapeyronie, Montpellier University Hospital, Montpellier, France.
authors.forename: Antoine
authors.initials: A
authors.lastname: de Runz
authors.affiliation: Drs Carloni, Watier, and Bertheuil are Plastic and Reconstructive Surgeons, and Dr Girard is a Fellow, Department of Plastic, Reconstructive, and Aesthetic Surgery, Hospital Sud, University of Rennes, Rennes, France. Dr Naudet is a Psychiatrist and Methodologist, Department of Psychiatry, Centre Hospitalier Guillaume Régnier, Rennes, France. Dr Chaput is a Plastic and Reconstructive Surgeon, Department of Plastic, Reconstructive, and Aesthetic Surgery, Rangueil Hospital, Paul Sabatier University, Toulouse, France. Dr de Runz is a Plastic and Reconstructive Surgeon, Department of Maxillofacial, Plastic, Reconstructive, and Cosmetic Surgery, Nancy University Hospital, Nancy, France. Dr Herlin is a Plastic and Reconstructive Surgeon, Department of Plastic Surgery and Burn Surgery, Hospital Lapeyronie, Montpellier University Hospital, Montpellier, France.
authors.forename: Christian
authors.initials: C
authors.lastname: Herlin
authors.affiliation: Drs Carloni, Watier, and Bertheuil are Plastic and Reconstructive Surgeons, and Dr Girard is a Fellow, Department of Plastic, Reconstructive, and Aesthetic Surgery, Hospital Sud, University of Rennes, Rennes, France. Dr Naudet is a Psychiatrist and Methodologist, Department of Psychiatry, Centre Hospitalier Guillaume Régnier, Rennes, France. Dr Chaput is a Plastic and Reconstructive Surgeon, Department of Plastic, Reconstructive, and Aesthetic Surgery, Rangueil Hospital, Paul Sabatier University, Toulouse, France. Dr de Runz is a Plastic and Reconstructive Surgeon, Department of Maxillofacial, Plastic, Reconstructive, and Cosmetic Surgery, Nancy University Hospital, Nancy, France. Dr Herlin is a Plastic and Reconstructive Surgeon, Department of Plastic Surgery and Burn Surgery, Hospital Lapeyronie, Montpellier University Hospital, Montpellier, France.
authors.forename: Paul
authors.initials: P
authors.lastname: Girard
authors.affiliation: Drs Carloni, Watier, and Bertheuil are Plastic and Reconstructive Surgeons, and Dr Girard is a Fellow, Department of Plastic, Reconstructive, and Aesthetic Surgery, Hospital Sud, University of Rennes, Rennes, France. Dr Naudet is a Psychiatrist and Methodologist, Department of Psychiatry, Centre Hospitalier Guillaume Régnier, Rennes, France. Dr Chaput is a Plastic and Reconstructive Surgeon, Department of Plastic, Reconstructive, and Aesthetic Surgery, Rangueil Hospital, Paul Sabatier University, Toulouse, France. Dr de Runz is a Plastic and Reconstructive Surgeon, Department of Maxillofacial, Plastic, Reconstructive, and Cosmetic Surgery, Nancy University Hospital, Nancy, France. Dr Herlin is a Plastic and Reconstructive Surgeon, Department of Plastic Surgery and Burn Surgery, Hospital Lapeyronie, Montpellier University Hospital, Montpellier, France.
authors.forename: Eric
authors.initials: E
authors.lastname: Watier
authors.affiliation: Drs Carloni, Watier, and Bertheuil are Plastic and Reconstructive Surgeons, and Dr Girard is a Fellow, Department of Plastic, Reconstructive, and Aesthetic Surgery, Hospital Sud, University of Rennes, Rennes, France. Dr Naudet is a Psychiatrist and Methodologist, Department of Psychiatry, Centre Hospitalier Guillaume Régnier, Rennes, France. Dr Chaput is a Plastic and Reconstructive Surgeon, Department of Plastic, Reconstructive, and Aesthetic Surgery, Rangueil Hospital, Paul Sabatier University, Toulouse, France. Dr de Runz is a Plastic and Reconstructive Surgeon, Department of Maxillofacial, Plastic, Reconstructive, and Cosmetic Surgery, Nancy University Hospital, Nancy, France. Dr Herlin is a Plastic and Reconstructive Surgeon, Department of Plastic Surgery and Burn Surgery, Hospital Lapeyronie, Montpellier University Hospital, Montpellier, France.
authors.forename: Nicolas
authors.initials: N
authors.lastname: Bertheuil
mesh_terms: D003357:Cosmetic Techniques / Q000009:adverse effects*; D006801:Humans; D011183:Postoperative Complications / Q000209:etiology*; D019651:Plastic Surgery Procedures / Q000009:adverse effects*; D018570:Risk Assessment; D012307:Risk Factors; D060726:Torso / Q000601:surgery*; D016896:Treatment Outcome; D015431:Weight Loss