Patients Can 'Benefit Immensely' from Body Contouring to Remove Excess Thigh Skin
Performed as part of the body contouring procedures in patients with massive weight loss, a procedure called medial thigh lift carries a substantial risk of complications, reports a study in the January issue of Plastic and Reconstructive Surgery®, the official medical journal of the American Society of Plastic Surgeons (ASPS).
"Wound complications in medial thighplasty are common, but most are minor and can be managed without reoperation," according to the new research by ASPS member surgeon, Dr. Jeffrey Adam Gusenoff and colleagues of University of Pittsburgh. The study is the first detailed look at complications after thigh lift surgery, performed as part of body contouring surgery after bariatric (weight reduction) surgery.
After Thigh Lift, Most Patients Have Mild Complications
Dr. Gusenoff and coauthors analyzed their experience with medial thigh lift in 106 patients with massive weight loss, mainly after bariatric surgery. The patients were 90 women and 16 men, average age 45 years. Most patients undergoing bariatric surgery for severe obesity are left with excess, sagging skin folds of the thigh and other areas.
Overall, 68 percent of patients experienced some type of complication after thigh lift surgery. The complication rate varied with the extensiveness of surgery: from 43 percent for patients undergoing the least-extensive "horizontal thighplasty," to 64 percent with an intermediate "short-scar thighplasty," to 74 percent with the most-extensive "full-length vertical thighplasty."
But while complications were frequent, they usually weren't serious. The most common issues were minor wound healing problems: problems with wound closure (dehiscence) and fluid collections (seromas). Most of these were managed without any further surgery.
Six percent of patients had complications requiring additional surgery. Another 14 percent underwent further surgery to improve their cosmetic results.
New Findings on Risk Factors for Complications
Leg swelling (edema) developed in 22 percent of patients—most undergoing the most-extensive type of thigh lift surgery. In all but two cases, the edema cleared up within a year after surgery.
Edema occurred mainly in patients undergoing the most extensive type of thigh lift, while seromas were more likely in patients with high blood pressure. Infections were more common in older patients, those with low thyroid function, and those undergoing liposuction at the same time as thigh lift.
With the increased use of bariatric surgery, the numbers of patients seeking body contouring surgery after massive weight loss have increased sharply. Thigh lift surgery has demonstrated functional and cosmetic benefits for patients, but concerns about complications may limit the use of this procedure.
The new study—the largest series of patients undergoing thigh lifting surgery reported to date—shows a high overall rate of complications, especially after the more-extensive procedures. However, most of these complications are relatively minor wound-healing issues, resolving without the need for further surgery. Swelling is also common, and also resolves over time in most cases.
"Despite these considerable challenges, massive weight loss patients also stand to benefit immensely from contouring procedures," Dr. Gusenoff and colleagues conclude. The researchers believe their results will be useful in counseling patients as to what to expect after thigh lift surgery. They also outline some steps that may help to reduce the risk of common complications, and call for further studies to compare the outcomes of different surgical techniques. Watch the accompanying " Hot Topics in Plastic Surgery Video."
About Plastic and Reconstructive Surgery
For more than 60 years, Plastic and Reconstructive Surgery® ( http://journals.lww.com/plasreconsurg/) has been the one consistently excellent reference for every specialist who uses plastic surgery techniques or works in conjunction with a plastic surgeon. The official journal of the American Society of Plastic Surgeons, Plastic and Reconstructive Surgery® brings subscribers up-to-the-minute reports on the latest techniques and follow-up for all areas of plastic and reconstructive surgery, including breast reconstruction, experimental studies, maxillofacial reconstruction, hand and microsurgery, burn repair, and cosmetic surgery, as well as news on medico-legal issues.
The American Society of Plastic Surgeons (ASPS) is the world's largest organization of board-certified plastic surgeons. Representing more than 7,000 Member Surgeons, the Society is recognized as a leading authority and information source on aesthetic and reconstructive plastic surgery. ASPS comprises more than 94 percent of all board-certified plastic surgeons in the United States. Founded in 1931, the Society represents physicians certified by The American Board of Plastic Surgery or The Royal College of Physicians and Surgeons of Canada. ASPS advances quality care to plastic surgery patients by encouraging high standards of training, ethics, physician practice and research in plastic surgery. You can learn more and visit the American Society of Plastic Surgeons at www.plasticsurgery.org or www.facebook.com/PlasticSurgeryASPS and www.twitter.com/ASPS_news.
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