title: Complications in body contouring stratified according to weight loss method.
abstract: BACKGROUND
  Body contouring procedures following massive weight loss have become increasingly common and, unfortunately, continue to be associated with a high complication rate.
  
  
  OBJECTIVE
  To evaluate how weight loss method affects complications following abdominally based body contouring procedures.
  
  
  METHODS
  Patients undergoing abdominally based contouring procedures were retrospectively evaluated over an 11-year period and stratified into two groups based on method of weight loss: diet and exercise; or bariatric surgery. Complications, including seroma, wound dehiscence, skin necrosis, infection, hematoma and venous thromboembolism, were included if they required intervention. An adjusted logistic model was used to examine the effect of weight loss method on aggregate complication rates.
  
  
  RESULTS
  A total of 307 patients were included: 77 (25%) lost weight through diet and exercise; and 230 (75%) through bariatric surgery. Results from the logistic model showed no difference in complication rates between weight loss methods (OR 1.01 [95% CI 0.51 to 2.02]). However, there was a strong correlation between body mass index at the time of surgery and complication rates (OR 1.05 [95% CI 1.02 to 1.08]; P<0.01).
  
  
  CONCLUSIONS
  The findings reveal no difference in complication rates following abdominal body contouring procedures attributable to method of weight loss. Rather, there was a proportional rise in complication rates in patients with a higher body mass index at the time of surgery. Surgeons and patients should be aware of this trend, and it should be part of any discussion of abdominal body contouring procedures and informing patients of their risk profile.
authors.affiliation: Section of Plastic Surgery, Department of Surgery, University of Michigan Health System, Ann Arbor, Michigan, USA.
authors.forename: Matthew D
authors.initials: MD
authors.lastname: Chetta
authors.affiliation: Section of Plastic Surgery, Department of Surgery, University of Michigan Health System, Ann Arbor, Michigan, USA.
authors.forename: Oluseyi
authors.initials: O
authors.lastname: Aliu
authors.affiliation: Division of Plastic Surgery, Department of Surgery, Indiana University School of Medicine, Indianapolis, Indiana, USA.
authors.forename: Bao Anh Patrick
authors.initials: BA
authors.lastname: Tran
authors.affiliation: Section of Plastic Surgery, Department of Surgery, University of Michigan Health System, Michigan, USA.
authors.forename: Mariam
authors.initials: M
authors.lastname: Abdulghani
authors.affiliation: Department of Biostatistics, University of Michigan, Michigan, USA.
authors.forename: Kelly M
authors.initials: KM
authors.lastname: Kidwell
authors.affiliation: Section of Plastic Surgery, Department of Surgery, University of Michigan Health System, Ann Arbor, Michigan, USA.
authors.forename: Adeyiza O
authors.initials: AO
authors.lastname: Momoh
keywords: Abdominoplasty; Bariatric surgery; Body contouring; Complications; Panniculectomy; Weight loss