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Liposuction of the arm concurrent with brachioplasty: A safe and effective single stage procedure for the massive weight loss (MWL) patient
Ronald P. Bossert, MD; Stephanie Dreifuss, BS; Adi Wollstein; Julio Clavijo, MD; Devin Coon, MD, J. Peter Rubin, MD
University of Pittsburgh Medical Center
2012-01-31
Presenter: Julio Clavijo, MD
Affidavit:
Dr. Clavijo assisted greatly in the conception of this project, background research, data collection, analysis and application of results to clinical practice.
Director Name: Dr. Joseph Losee, MD
Author Category: Chief Resident Plastic Surgery
Presentation Category: Clinical
Abstract Category: Aesthetics
How does this presentation meet the established conference educational objectives?
This presentation will educate the audience on the efficacy and safety of arm liposuction performed concurrently with excisional brachioplasty in the massive weight loss population. This is a topic of debate in the literature. Herein, we demonstrate that liposuction is a safe, effective adjunct to excisional brachioplasty as a single stage procedure.
How will your presentation be used by practicing physicians in the audience?
Massive weight loss patients who would benefit from debulking of the arm via liposuction as well as excision of excess skin and fat may be approached safely as a single stage procedure. Clinicians may have previously performed these procedures in a staged fashion. The abstract submitted demonstrates that these tools may be used concurrently and thus alter practice patterns of clinicians.
BACKGROUND Brachioplasty is commonly performed in the MWL population, and the safety of concurrent arm liposuction has been questioned. Using an IRB approved database registry, we sought to determine the complication rates for brachioplasty performed with and without concurrent liposuction.
METHODS A retrospective analysis was performed of 144 massive weight loss patients (288 arms) who had undergone brachioplasty with or without concurrent arm liposuction outside the region of excision. Variables considered included age, gender, BMI indices, co-morbidities, tobacco use, and nutritional parameters. Complications specific to the arms, including wound dehiscence, seroma, surgical site infection, hematoma, lymphedema and need for revisional procedures were analyzed.
RESULTS One hundred forty four patients (139 women and 5 men) with an average age of 45.8 years underwent brachioplasty. Sixty-four patients (44.7%) with an average mean body mass index of 30.6kg/m2 (+/- 4.0) had liposuction performed on the arms at the time of brachioplasty. Average lipoaspirate per arm was 278cc (+/- 426). Eighty patients (55.3%) with an average mean body mass index of 28.8kg/m2 (+/- 4.1) underwent excisional brachioplasty alone. Patients undergoing liposuction had significantly higher BMIs (p<0.05). Multivariate analysis revealed no significant difference in rates of wound dehiscence, seroma, infection, hematoma, lymphedema or revisional procedures between the two groups.
CONCLUSION Arm liposuction performed concurrently with brachioplasty can be done with no higher risk of complications than excisional brachioplasty alone.
