D137. Effect of Elevated Body Mass on Surgical Complications in Patients Undergoing Body Contouring after Massive Weight Loss

Abstract

PURPOSE: Massive weight loss can result in whole-body deformities that often are addressed with body contouring. However, even after weight loss, many patients have residual obesity. In this study, we aim to determine the effect of BMI on post-bariatric reconstructive surgery complications. METHODS: Patients undergoing body contouring from 2002-2018 after massive weight loss (≥50 pounds) were retrospectively reviewed. Variables of interest include pre and post weight loss BMI, post-operative complications, and procedures per case. RESULTS: In this cohort, 942 massive weight loss patients underwent 1,063 cases involving 1,814 procedures. 884 patients were female while 58 were male. Mean pre-weight loss BMI, or max BMI, was 51.9 ±9.8 while mean post weight loss BMI was 30.5 ±6.0. For all cases, an increased maximum BMI (p=0.006), but not current BMI, was associated with a higher rate of post-operative complications. Increased current BMI significantly amplified the risk of post-operative fat necrosis (p<0.01) while elevated maximum BMI increased the risk of seroma (p<0.01) and wound infection (p<0.05). In patients with multiple procedures (n= 502), increased maximum and current BMI were associated with higher risk of seroma formation (p<0.05), but neither was associated with risk of seroma for single procedures cases (n=561). CONCLUSION: Both pre and post weight loss BMIs play a role in complication rate and type, while only max BMI plays a role in multiple procedure cases. These findings indicate that pre and post weight loss BMI should be assessed, in addition to number of procedures, to optimize outcomes after body contouring.