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Outcomes of patients older than 55 years undergoing abdominoplasty after bariatric surgery
Authors:Tarek Debs  Niccolo Petrucciani  Sebastian Frey  Carine Korkmaz  Katharina Hufschmidt  Eric Sejor  Houssam Eddine Bitar  Imed Ben Amor  Antonio Iannelli  Jean Gugenheim
Institution:1. Division of Digestive Surgery and Liver Transplantation, Nice University Hospital, Nice, France;2. Department of Medical and Surgical Sciences and Translational Medicine, Sant’Andrea Hospital, Sapienza University, Rome, Italy;3. Department of Plastic and Reconstructive Surgery, University Hospital Nice, Nice, France
Abstract:BackgroundBariatric 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.ObjectivesTo analyze the feasibility and the safety of abdominoplasty in patients older than 55 years old after bariatric surgery.SettingUniversity hospital medical center.MethodsWe 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.ResultsWe 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.ConclusionAbdominoplasty 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.
Keywords:Abdominoplasty  Elderly  older than 55 years old  Bariatric surgery  Weight loss  Sleeve gastrectomy  Gastric bypass  Complications  Outcomes
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