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The Constriction Arm Band Deformity in Brachioplasty Patients: Characterization and Incidence Using a Prospective Registry
Chen W; James IB; Gusenoff JA; Rubin JP.
University of Pittsburgh Medical Center
2017-01-28
Presenter: Wendy Chen, MD, MS
Affidavit:
This resident did the majority of the work acquiring data, writing the abstract, modifying the design of the study, and directing statistical analysis.
Director Name: Vu T Nguyen
Author Category: Resident Plastic Surgery
Presentation Category: Clinical
Abstract Category: Aesthetics
Introduction: Brachioplasty has seen a dramatic increase in the USA, with 17,099 cases in 2015. We describe an anatomic deformity associated with brachioplasty that has not been well defined in the literature and is often thought to be a complication of surgery.
Methods: Photographs of patients in our IRB approved Life After Weight Loss registry undergoing brachioplasty at our institution (2000-2016) were evaluated to determine incidence and morphology of post-operative constriction bands. Preoperative photographs and comorbidities were correlated.
Results:
In our cohort of 1,090 MWL patients, 172 patients underwent brachioplasty and 25 (15%) were identified with the deformity. Twenty-four (96%) were female with average age 60y [range 36y to 85y], BMI 34kg/m2 at time of surgery, 2ys since GBP, and mean delta BMI 22kg/m2. When present, one band was observed per arm (100%), and the deformity bilateral in 68%. Bands were in the distal third of the upper arm in 74%. The average combined specimen weighed 1005g, and arm banding was associated with higher BMI at time of operation than patients without the finding (p = 0.002). Importantly, this finding was present preoperatively in all cases and often exacerbated (50%) by brachioplasty.
Discussion/Conclusion:
The constriction arm band deformity occurs in 15% of patients and is more common with higher BMI and large resection weight. It is usually present preoperatively and not a routine complication of brachioplasty, highlighting the importance of preoperative identification and counseling.
