Retrospective analysis of the predictive factors associated with good surgical outcome in brachioplasty in massive weight loss patients

Abstract

Background

Upper arm lift is a widespread body contouring procedure, but no globally accepted guidelines exist in selecting patients and, due to comorbidity and heterogeneity of them, it is difficult to identify predictive factors of good surgical outcome. The authors review the team’s experience of 56 brachioplasty performed in massive weighs loss patients.

Methods

Data of 56 consecutive arm lifts were reviewed for preoperative, perioperative and postoperative variables and outcomes (complications, scarring, wound healing, revision surgery, need for blood transfusion, satisfaction, etc.). Surgical technique and postoperative care are described. A statistical analysis was performed to identify relationship between possible predictive factors and outcomes. Furthermore, an evaluation of different employed wound management devices was conducted.

Results

Follow-up ranged from 6 to 36 months (mean 20.1 months). Outcomes summary is reported (overall complication rate 50%, poor scarring rate 25%, delayed wound healing rate 26.8%, revision surgery rate 37.5%, need for blood transfusion rate 8.9%, satisfaction rate 71.4%) and statistical investigation evidenced the role of prior plastic surgery BMI and the associated change in BMI before and after weight loss, just prior brachioplasty, and the modality of weight loss.

Conclusion

The authors’ technique resulted in positive outcomes overall, considering the difficulty in dealing with the problems of MWL patients. Based on our results, we aim to suggest to perform brachioplasty in patient with the lower achievable BMI (preferably <30kg/m2) to reduce the negative effect of unmodifiable factors as diabetes, modality of weight loss, a wide ΔBMI, and other well-known negative predictive factors.

Keywords:

• Brachioplasty
• body contouring surgery
• arm lift
• massive weight loss
• obesity
• BMI
• postbariatric surgery

Ethical approval

Requirements of the Declaration of Helsinki as well as principles of GCP were taken into consideration. Patients gave full consent to use their personal data. Institutional review board approval was obtained before conducting the study.

Disclosure statement

None of the authors has a financial interest in any of the products, devices, or drugs mentioned in this manuscript. No funding was received for this article.

Prof. Franco Bassetto has to declare the relevant financial activities outside the submitted work, during the 36 months prior to publication:

• Klox: fees for consultancy and investigator

• Smith and Nephew: fees for consultancy and investigator

• Urgo Medical: fees for consultancy and advisory board

• Acelity: fees for consultancy

• Medtronic: fees for consultancy

• Rigenera: fees for consultancy

• Molnlycke: fees for consultancy

• Sofar: fees for investigator