Body-contouring Surgery Research Articles

"Weight Control Following Body Contouring Surgery - Long-Term Assessment of Postbariatric and Non-bariatric Patients".

Few reports of weight maintenance following body contouring (BC) surgery present weight measurements as percent weight change, and most of these studies do not isolate BC to specific body areas. This study analyzes weight control in the trunk-based BC population and further compares BC outcomes in postbariatric and non-bariatric patients. We performed a retrospective cohort study of consecutive postbariatric and non-bariatric patients who underwent trunk-based BC (abdominoplasty, panniculectomy, and circumferential lipectomy) from 1/1/2009 through 7/31/2020 at West Virginia University. A minimum twelve-month follow-up was required for inclusion. With BC surgery date as the reference point, percent total weight loss (%TWL) was assessed at six-month intervals for two years following BC and every year thereafter. Change over time was compared between postbariatric and non-bariatric patients. Within the twelve-year timeframe, 121 patients meeting criteria underwent trunk-based BC. Average follow-up from date of BC was 42.9 months. Sixty patients (49.6 %) had previously undergone bariatric surgery. From pre-BC to endpoint follow-up, postbariatric and non-bariatric patients experienced a 4.39 ± 10.93% and 0.25 ± 9.43% increase in weight from baseline, respectively (p=0.0273). Once nadir weight loss was attained, weight regain occurred through endpoint follow-up in both groups (11.81% in the postbariatric patients and 7.56% in the non-bariatric BC cohort, p=0.0106). Long-term weight regain is common following trunk-based BC surgeries, specifically in postbariatric patients. Although this should not contend with the psychological benefit of removing this excess tissue, it is important to report results with ideal weight metrics to optimally assess outcomes in this population.

Treating Saddlebag Deformity after Massive Weight Loss: Vertical versus Lower Body Lift.

The saddlebag deformity remains a persistent and difficult-to-treat problem after body-contouring surgery. A new way to handle the saddlebag deformity is with the vertical lower body lift (VLBL). This retrospective cohort study evaluated the overall reconstruction outcome of the VLBL in 16 patients (32 saddlebags) and compared it to standard lower body lift (LBL). The BODY-Q and the Pittsburgh Rating Scale (PRS)-Saddlebag Scale were used in the evaluation process. Surgical outcomes regarding the saddlebag deformity were in favor of the VLBL technique in patients with marked saddlebag deformity. A 1.16 decrease in mean PRS saddlebag score (relative change of 61.7%) was observed for the VLBL group versus a mean decrease of 0.29 (relative change of 21.6%) in the LBL group. BODY-Q end point and change in scores did not differ between the VLBL and LBL groups at 3-month follow-up, but at 1-year follow-up, they were in favor of the VLBL group in the body appraisal domain. Patients were highly satisfied with the contour and appearance of their lateral thigh, despite the extra scarring caused by this novel technique. Therefore, the authors advise clinicians to consider performing a VLBL instead of the standard LBL in patients with notable saddlebag deformities after massive weight loss. Therapeutic, III.

Lipoabdominoplasty: What We Have Implemented and What We Have Modified over 26 Years.

Lipoabdominoplasty is one of the most commonly performed procedures in body-contouring surgery. We present a retrospective study of our 26 years of experience to improve the results and assure the greatest possible safety in lipoabdominoplasty. We include all of our female patients who underwent lipoabdominoplasty performed from July 1996 to June 2022, dividing the patients into two groups: group I underwent circumferential liposuction avoiding abdominal flap liposuction for the first 7 years, and group II underwent circumferential liposuction including abdominal flap liposuction for the subsequent 19 years, pointing out the differences in the processes, results, and complications of both groups. Over a period of 26 years, 973 female patients underwent lipoabdominoplasty: 310 in group I and 663 in group II. Ages were very similar; however, weight, BMI, amount of liposuction material, and weight of the abdominal flap removed were higher in group I. Twenty percent of patients in group I were obese compared to 7% in group II. The average amount of liposuction in group I was 4990 mL compared to 3373 mL in group II and 1120 g of abdominal flap in group I versus 676 g in group II. Minor and major complications were 11.6% and 1.2% in group I versus 9.2% and 0.6% in group II, respectively. In our more than 26 years of performing lipoabdominoplasty, we have maintained most of our initial procedures. These processes have allowed us to perform surgery safely and effectively with a low morbidity rate.

Quality of Life After Bariatric and Body Contouring Surgery in the Australian Public Health System

IntroductionThe goals of bariatric surgery are weight loss, improved management of obesity-related diseases, and enhanced health-related quality of life (HRQoL). The aim of this study is to determine HRQoL among postoperative bariatric surgery patients. The aim of this study was to evaluate the utility of bariatric surgery and the role of body contouring surgery (BCS) when considering quality of life in low-volume centres in the Australian public health system. MethodsThis cohort study compared patients who underwent bariatric surgery between 2008 and 2018, to those awaiting surgery. An additional analysis was completed for patients who also underwent BCS. Patients completed the Short Form-36 quality of life (SF-36) survey. Linear regression was used to assess the differences in mean scores between cohorts for each of the SF-36 domains. ResultsA total of 131 postoperative patients were identified, with a follow up rate of 68%. The mean follow up was 5.4 y. The mean scores for all domains of the SF-36 in the postoperative group were higher than the preoperative group (P ≤ 0.0001). A significant difference in scores persisted after controlling for patients’ current BMI. When considering patients who underwent BCS (n = 24), there was a further global improvement in HRQoL in physical function (P = 0.0065), role limitation to physical health (P = 0.0026), pain (P = 0.0004), energy (P = 0.0023) and general health perceptions (P = 0.0023). ConclusionsBariatric surgery followed by BCS may improve HRQoL for the patient when compared to bariatric surgery alone. We advocate for the use of bariatric surgery followed by BCS in low-volume centres in the Australian public health system.

Comparing Bariatric Surgery Patients Who Desire, Have Undergone, or Have No Desire for Body Contouring Surgery: a 5-Year Prospective Study of Body Image and Mental Health

PurposeAfter bariatric surgery, body contouring surgery (BCS) is thought to improve body image, weight loss, and mental health. Many patients desire but do not undergo BCS after bariatric surgery. This patient subset has rarely been studied. The present study compares bariatric surgery patients that, at 5 years after surgery, desires, have undergone or have no desire for BCS regarding pre- and post-surgery body image and mental health, including within-group changes over time.Materials and MethodsData were collected from participants (N = 216) pre-bariatric surgery and at 1- and 5-year post-surgery. Health care providers measured body mass index (BMI). All other data were collected via self-report (questionnaires).ResultsAt 5-year post-surgery, 30.6% had undergone BCS, 17.1% did not desire it, and 52.3% desired BCS. Patients who subsequently desired BCS scored lower on body satisfaction pre-surgery than the other groups. They also reported less resilience pre-surgery and more depressive symptoms at all times compared to participants with BCS. For five-year post-surgery, patients who desired BCS had lower body satisfaction levels than patients with BCS and were more bothered with excess skin relative to the two other groups. Body satisfaction improved in all three groups from baseline to five years and in most patients with BCS. Mental health improved only in patients with BCS.ConclusionThis study emphasizes the relevance of identifying participants who desire but have not undergone BCS. The study suggests that BCS is associated with improved body image and mental health.Graphical abstract

Awareness about Advantages and Disadvantages of Abdominoplasty in the Kingdom of Saudi Arabia

Background: Abdominoplasty (AP) is a pervasive procedure in cosmetic clinics with spectrum cosmetic reasons used globally under the giant umbrella of enhancing the quality of life. In Saudi Arabia (KSA), AP is the most common requested body-contouring surgery. It is associated with a significant number of complications, thus, there is a need to increase the clinical knowledge of physicians about AP to increase their clinical management ability of these patients as well raise the awareness of potential patients. Aim of study: The study aims to increase the awareness about advantages and disadvantages of AP among Saudi physicians and patients going to have an AP surgery. Methodology: The study adopts a quantitative descriptive approach among public and private cosmetic clinics practicing AP surgery. An online questionnaire form was distributed to patients who had AP surgery. Results: total of 229 patients participated in this study, 172 (75.1%) males and 57 (24.9%) females. One third of participants with BMI >30. The main reasons of performing AP surgery were cosmetics (96.9%), weight loss (86.9%), sagging skin (67.2%) and stretch marks (42.8%). only 12.2% need to re-correct their primary operations and majority (89.9 %%) reported a positive response of AP satisfaction, weight loss (67.9%) and emotional and social benefits (66.4%). Conclusion: We conclude that most of the study participants were satisfied with their results. Unfortunately, there is a lack of data in Saudi Arabia, and this study somewhat fulfill the current gap about the advantages and disadvantages of AP surgery. Keywords: Cosmetic Surgery, Risks post Abdominoplasty, Advantages & Disadvantages, Obesity, KSA.

Male Lower Extremity Sculpting.

The muscular sculpture (MS) is a new technique of male body contouring to achieve: tight skin that very well reveals muscular bulk, a male muscular and athletic body, minimal observable scars and even patients who are not, nor have been in. With this study, we describe the new technique for sculpting of lower extremities. In literature are not described techniques to accomplish a sound aesthetic result in sculpting surgery about lower extremities. For this surgical procedure, we illustrate the technique that was obtained from 5 male patients (principles outlined in the Declaration of Helsinki have been followed). We describe this surgery with six steps: defatting step; MS; internal scar removal; irregularity removal; dermal grasping; last residues of fat removing. We obtain a high satisfaction rate as high as 100% for short and long term. Compared to the complications more described in literature (infection, hematoma, seroma, wound dehiscence, hypertrophic scars, sensory nerve injury and recurrent skin laxity, Monarca and Rizzo in Aesthetic Plast Surg 39(2):199-202, 2015), we have not had complications. We had no major complications. We observed, with our other studies, a direct relationship between complications and smoking habit. Successful body-contouring surgery requires a patient to embrace positive lifestyle habits: exercise, a proper diet and other positive lifestyle changes (Monarca et al. in Plast Reconstr Surg 123(5):1637-1638, 2009), and a high compliance and to avoid all the excesses. We obtain amazing aesthetic results with total patient satisfaction without complications. There are not enough studies in the literature about body sculpting, and is necessary to deepen this technique in order to obtain increasingly encouraging results. Sculpting surgery, Body contouring, 41 leg surgery, adipose tissue. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

One key to fit all locks? Routine internal drainage to minimize seromas during thigh lift surgeries

Obesity is a worldwide epidemic. Complication rates after body contouring surgeries in massive weight loss patients were quite high, with seroma development being the second most common complication, reported rates averaging 15%-40%, Methods described to reduce the annoying high rate of seroma did not have a statistically significant difference in reducing seromas. Our aim was to find a universal solution that could be used with any body-contouring surgery to manage seromas. We tried this novel technique initially on thigh lifts. Instead of wading in the jungle of methods aiming at preventing seromas, we contemplated a drainage channel that would continuously drain any fluid accumulation. The idea was borrowed from the hypothesis of Thompson on lymphoedema management. By excising an area of deep fascia overlying the Vastus Medialis muscle, the muscle would be directly exposed to any seroma fluid and would imbibe it as blotting paper. Furthermore, this technique would open new drainage channels between the superficial and deep lymphatics. This technique was tried in 20 patients, with the excision of deep fascia carried only in one limb. The other limb was left as a control. Rates of seroma formation were noted and duration before it dried up. This technique significantly reduced the incidence of detected seromas and the amount of seroma fluid. This technique reduced the incidence of seroma formation, and is recommended for routine use during all thigh lift surgeries.

Changes in Glucose Control and Lipid Levels Following Trunk-Based Body Contouring Surgery in Postbariatric and Nonbariatric Patients.

Despite consistent interest over the past 2 decades regarding the metabolic effects of body contouring (BC), previous studies are limited by short follow-up periods, small sample sizes, gender-specific cohorts, and assessment of all anatomic regions together. This study evaluates the changes in glucose and lipid levels over long-term follow up after trunk-based BC and compares postbariatric with nonbariatric patients. The retrospective cohort study included patients who underwent trunk-based BC from January 1, 2009 through July 31, 2020 at West Virginia University. A minimum 12-month follow up was required for inclusion. With BC surgery as the reference point, patients' glucose, hemoglobin A1c, and lipid levels were assessed prior to surgery and at long-term follow up. Change over time was compared between postbariatric and nonbariatric cohorts. Multivariable linear regression models were performed to assess the effect of potential confounding variables on the difference between cohorts. Seventy-seven BC patients had glucose levels evaluated during the study period, and 36 had lipid profiles obtained. Average follow up from date of BC was 41.2 months for the patients with glucose follow up and 40.9 months for those with lipid levels. From pre-BC to endpoint follow up, glucose levels mildly increased in all patients. Multivariable linear regression models accounting for age showed nonbariatric patients experience significantly improved total cholesterol levels compared to postbariatric patients (P = 0.0320). Weight loss maintained following BC was not associated with significant differences between cohorts. Fasting glucose levels marginally increase in most BC patients through follow up. Nonbariatric patients generally experience more favorable changes in lipid profile following trunk-based BC than do postbariatric patients.

Long-Term Weight Loss with Body Contour Surgery After Roux-en-Y Gastric Bypass.

Bariatric surgery is accepted as an evidence-based treatment for morbid obesity. Many patients seek out body contour surgery afterwards to correct acquired deformities. This study seeks to better define the impact of body contour surgery on long-term weight loss. This study is a single-center retrospective review of 78 patients who underwent body contouring surgery post-Roux-en-Y gastric bypass compared with 221 matched control patients who underwent Roux-en-Y gastric bypass only. Data was collected for patients at least 7 years post-Roux-en-Y gastric bypass. Patients who underwent both bariatric surgery and body contour surgery maintained mean long-term weight loss of 58 kg. The matched control group mean weight loss over the same time interval was 42 kg. The difference was statistically and clinically significant (p = 0.005). Change in body mass index, percent total weight loss, and percent excess body mass index loss were all statistically significant between the 2 groups. Patients who underwent body contour surgery better maintained long-term weight reduction in comparison to those who only had gastric bypass. Further understanding of the etiology of this association is important for patients contemplating body contouring surgery.

Male-to-female gender affirmation surgery: breast reconstruction with Ergonomix round prostheses.

People with gender dysphoria are becoming more prevalent and more universally accepted. Social, hormonal, and surgical gender transition are ableto substantially improve their quality of life. Various gender affirmation surgery (GAS) options are available to address gender dysphoria in the male-to-female (MtF) population, including facial and chest feminization, body contouring, and genital surgery. While hormone replacement therapy may result in some degree of breast development, it is often insufficient to effectively result in an adequate female-like breast contour. The creation of a female chest is generally the first surgical step in the transition. The primary aim of this manuscript is to describe the surgical technique with ergonomix round prostheses used at our high-volume GAS center and to point out how anatomical differences between trans-female and cis-female patients impact surgery. Furthermore, we provide an overview of the demographic data and postoperative outcomes.

A systematic review of body contouring surgery in post-bariatric patients to determine its prevalence, effects on quality of life, desire, and barriers.

Many post-bariatric patients have impaired health-related quality of life (HRQoL) due to excess skin following weight loss; however, it is inconclusive whether body contouring surgery (BCS) improves this impairment. We aimed to comprehensively summarize existing evidence of the effect of BCS on the HRQoL (primary outcome) and determine the prevalence of, the desire for, and barriers to BCS (secondary outcomes). Randomized controlled trials, cohort, cross-sectional, case-control, and longitudinal studies were systematically searched in PubMed, Embase, the Cochrane Central, and Web of Science. After screening 1923 potential records, 24 studies (representing 6867 participants) were deemed eligible. Only 18.5% of respondents from cross-sectional studies underwent BCS, with abdominal BCS as the most common procedure. Most participants desired BCS but listed "cost" and "lacking reimbursement" as the main barriers. Results suggest that most post-bariatric patients who underwent BCS experienced improvements in their HRQoL, which could be seen in almost every dimension evaluated, including body image and physical and psychosocial functions. Therefore, both bariatric and plastic surgeons should regard BCS not only as an aesthetic supplement but also as a vital part of functional recovery in the surgery-mediated weight loss journey and, thus, provide it to more post-bariatric patients.

Outcomes of patients older than 55 years undergoing abdominoplasty after bariatric surgery.

Bariatric surgery has become widely performed for treating patients with morbid obesity, and the age limits are being pushed further and further as the procedure proves safe. After massive weight loss, many of those patients seek body-contouring surgery for excess skin and fat. To analyze the feasibility and the safety of abdominoplasty in patients older than 55 years old after bariatric surgery. University hospital medical center. We performed a retrospective review of prospectively collected data from patients aged older than 55 years who had undergone abdominoplasty following massive weight loss due to a bariatric surgery at a single institution from 2004 to 2017. The data analyzed included age, gender, preoperative body mass index, associated interventions, co-morbidities, and postoperative complications. We retrieved records for 104 patients; 85.6% percent of them were female, and the mean age was 60.1 ± 3.9 years old. Of the 104 patients, 21 (20.2%) underwent a sleeve gastrectomy and 77 (74%) underwent a Roux-en-Y gastric bypass. The mean interval between the bariatric surgery and the abdominoplasty was 33.6 ± 26.9 months. The mean preoperative weight and body mass index were 76.1 ± 14.5 kg and 28.9 ± 4.5 kg/m2, respectively. A total complication rate of 20% was observed. The only factor significantly associated with postoperative morbidity was the associated procedure (P = .03), when we performed another procedure at the same time as the abdominoplasty. Complications included postoperative bleeding in 5 patients (4.8%), seromas in 5 patients (4.8%), surgical site infections in 12 patients (11.5%), and wound dehiscence or ischemia in 2 patients (1.9%). No mortality occurred. Abdominoplasty can be safely performed in carefully selected patients older than 55 years old after weight loss surgery, and does not present increased morbidity or mortality. We recommend that surgeons avoid adding concomitant procedures when possible, to decrease the risk of complications. It is also important to look at the patient's previous maximum BMI levels, as a higher maximum BMI can predict higher postoperative risks and longer hospital stays.

Is body-contouring surgery a right for massive weight loss patients? A survey through the European Union National Health Systems

BackgroundObesity is pandemic nowadays, and hanging skin with consequent functional and psychological impairments is a common price to pay for massive weight loss. Plastic surgery in postbariatric patients represents a fundamental step to regain possession of a positive self-image. The authors aimed to investigate how EU countries’ National Health System (NHS) behaves regarding reimbursements for body-contouring procedures after massive weight loss.MethodsA 1-item survey was sent to contacts found on the NHS official Web sites of 27 EU countries. The question focused on postbariatric surgery practice and investigated the accessibility criteria for NHS coverage concerning body-contouring procedures after massive weight loss.ResultsResponses were collected between January 2020 and February 2020. Response rate was 65%, and access criteria to NHS coverage for postbariatric surgery presented great variation across EU countries. Only one country presented an NHS with no coverage for postbariatric surgeries.ConclusionsDespite the conspicuous variability found among the EU NHS, none of them admit reimbursement in cases of merely aesthetic procedures: postbariatric patients need to display functional or health impairments due to the extensive weight loss. The results of the current study describe a complex situation among EU countries, but a common lead towards postbariatric patients’ care shows off. The ultimate goal of bariatric patient’s healing should be full restoration of physical and psychological well-being. NHS of EU countries are facing this increasing request in various ways, and more studies should be performed in order to understand which is the best approach.Level of evidence: Not ratable.

Experience of Excess Skin and Attitude to Body Contouring Surgery of a Chinese Post-Bariatric Population

Introduction: Western studies have explored post-bariatric patients concerning their views on excess skin and body contouring surgery (BCS), but Asian data were lacking. This study aims to investigate the experience of excess skin and attitude to BCS of a Chinese post-bariatric population. Methods: A total of 210 Chinese patients who underwent bariatric surgery from March 2015 to September 2018 were cross-sectional studied using the Sahlgrenska Excess Skin Questionnaire and a study-specific questionnaire. Results: The survey response rate was 61.4%. Most responders (78.2%) reported they had excess skin, and the most common sites were the abdomen (70.2%) and the upper arms (61.3%). Most responders (66.1%) reported being bothered by impaired health-related quality of life (HRQoL), and the most common problem was “the feeling of having unattractive body appearance” (42.7%). Many patients (37.9%) desired for BCS, and “the impact of excess skin is not serious enough” was the reason why not undergoing BCS being chosen most (28.1%), then “the cost is too high” (20.2%) and “worrying about the risk or complications of BCS” (18.4%). Younger age, female gender, higher weight loss, having full-time job, and earning higher income were independent factors increasing their desires for BCS. Conclusions: Most Chinese post-bariatric patients have excess skin and are bothered by impaired HRQoL. The abdomen and upper arms are the sites where patients are most seriously affected and most eager for BCS. The conservative attitude toward BCS and the cost without reimbursement are the main barriers.

Post-bariatric body contouring surgery: analysis of complications in 180 consecutive patients.

bariatric surgery is the main treatment for cases of severe obesity and body contour surgery to correct body dysmorphia resulting from weight loss. However, these procedures are associated with a significant number of postoperative complications. this study aims to analyze complications in post-bariatric patients undergoing body contour surgeries and correlating them with the age and BMI of these patients. the current study is a retrospective study evaluating 180 consecutive patients undergoing body contour surgery after bariatric surgery within a period of three years (2014-2016). Data such as age, gender, Body Mass Index before bariatric and plastic surgeries, type of surgery performed and complications were collected, and correlated the age as well as the BMI of the patients in the pre-bariatric (PB) and pre-plastic (PP) periods with the complications presented. of the 180 patients evaluated, 91.7% were females (n = 165), and the mean age was 46.3 ± 1.7 years. The most performed surgery was abdominoplasty (48.9%), followed by mammaplasty (21.1%). Some complications occurred in 26.1% of the patients with partial dehiscence (40.4%) and seroma (14.9%) being the most frequent. Patients who presented complications had a higher mean age (50.8 years) than those who presented with no complications, and major complications accounted for 2.7% of the sample. a statistically significant number of surgeries progressed without complications and, when they occurred, there were minor complications in most of the sample. Complications were more frequent in older patients with some of them having a BMI over 30 Kg/m2.

Body Contouring Surgery Improves Weight Loss after Bariatric Surgery: A Systematic Review and Meta-Analysis.

Our main objective is to evaluate the effect of body contouring surgery (BCS) on the magnitude and durability of weight loss after bariatric surgery. Medline, EMBASE, Cochrane, and Scopus search were conducted from the time of their inception to June 2020. We included comparative studies that assessed weight progression, in terms of Body Mass Index change (∆BMI), Total Body Weight Loss (TBWL%), and Excess Weight Loss (%EWL) for the post-bariatric patient population and the effect of BCS on weight progression. Eleven articles were included. The pooled sample size was 2307, of which 691 were cases who underwent BCS post-bariatric surgery, and 1616 were comparative controls. The mean follow-up time for cases and controls were 61.6 ± 23.8months and 52.2 ± 23.8months, respectively. Nine studies reported results of BMI changes, six provided %EWL, and five used %TBWL. Significant improvement in weight loss was observed in the BCS group when measured by either ∆BMI (3kg/m2 points decrease, p 0.023), %TBWL (6% increase, P < 0.0001), or %EWL (14% increase, P < 0.0001). Sub-group analysis showed that increased follow-up timewas associated with higher TBWL% (p 0.02). The evidence provided in this review strongly supports the added long-term benefits of body contouring surgery for selected patients after massive weight loss following bariatric surgery. Having a multidisciplinary team that involves a bariatric and a plastic surgeon as well as nutritionists and psychologists for the management of patients with obesity going through the bariatric pathway is recommended. This journal requires that authors assign a level of evidence to each article. For a full description of these evidence-based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.

Fibrin Sealant Artiss Compared to Progressive Tension Sutures With Stratafix in the Management of Wound Drainage Following Post-Bariatric Body-Contouring Surgery.

Post-bariatric body-contouring surgery is one of the most rapidly growing areas in plastic surgery. One of the most common complications following post-bariatric body-contouring surgery is seroma. There are a number of approaches to reducing wound drainage and seroma formation. A promising strategy to reduce these complications is to develop effective methods for reducing dead space between the tissue layers. We conducted a retrospective trial assessing the use of human fibrin sealant Artiss in comparison to progressive tension sutures (PTS) with Stratafix, a bidirectional barbed suture device in patients undergoing post-bariatric body-contouring surgery. Thirty-six patients for abdominoplasty or lower-body-lift were evaluated. Treatment patients underwent procedure with fibrin sealant applied to adapt the tissue layers. Control patients underwent an identical procedure but with PTS. Primary outcome measures included total wound drainage and time to drain removal. The use of Artiss in abdominoplasty was associated with a mean drain volume that was significantly higher and more days that were needed to remove all drains compared to the PTS group. In body-lift, the mean drain volume and number of days needed to remove all drains tended to be higher when using Artiss compared to the PTS group. The use of Artiss in post-bariatric body-contouring surgery did not decrease the rate of seromas and the length of time required for post-surgical drains when compared to PTS.

A new role for anandamide: defective link between the systemic and skin endocannabinoid systems in hypertrophic human wound healing

The use of cannabinoids to treat fibrotic skin diseases is an emergent issue. Therefore, we aimed to evaluate systemic and skin endocannabinoid responses in the wound-healing process in humans. A prospective study was performed in 50 patients who underwent body-contouring surgery. Anandamide (N-arachidonoylethanolamine, AEA), 2-arachidonoylglycerol (2-AG), palmitoylethanolamide (PEA) and oleoylethanolamide (OEA) were quantified using LC–MS/MS. Ten (20%) patients developed hypertrophic (HT) scars. No significant changes were observed between the normal (N) scar and HT scar groups in terms of plasma and skin endocannabinoids. Nevertheless, a positive correlation between plasma and skin AEA concentrations was found in the N group (r = 0.38, p = 0.015), which was absent in the HT group. Moreover, the AEA concentration was significantly lower in HT scar tissue than in normal scar tissue (0.77 ± 0.12 ng/g vs 1.15 ± 0.15 ng/g, p < 0.001). Interestingly, in all patients, the surgical intervention produced a time-dependent effect with a U shape for AEA, PEA and OEA plasma concentrations. In contrast, 2-AG plasma concentrations increased 5 days after surgery and were reduced and stabilized 3 months later. These results suggest crosstalk between systemic and local skin endocannabinoid systems during human wound healing. AEA appears to be the most likely candidate for this link, which is deficient in patients with HT scars.

Liposuction: Concepts, safety, and techniques in body-contouring surgery.

Liposuction is the second most commonly performed cosmetic surgery in the United States and the most common surgical procedure in patients between the ages of 35 and 64; practitioners of medicine and surgery will undoubtedly encounter these patients in their practice. This brief review discusses the role of liposuction and fat transfer in aesthetic and reconstructive surgery, as well as key considerations, indications, and safety concerns.