Body Contouring Surgery Risk Rises with Increased Body Mass Index

In order to determine the degree of risk associated with obesity when undergoing body contouring surgery, a retrospective review was conducted of 129 patients who underwent a single body contouring procedure from 1993 and 2002.  Patients were categorized based on their body mass index (BMI), clinical degree of being overweight, into groups including ideal (BMI <25), overweight (BMI 25-30), obese (BMI 31-35), morbidly obese (BMI 36-40), and severely morbidly obese (BMI >41).  Complications were recorded into minor and major categories: minor complications included postoperative wound infection, or pockets of fluid (seroma) or blood (hematoma) in or around the wound; major complications included any wound requiring dressing changes, need for hospital readmission or prolonged admission, need for re-operation, or death. 

Of the total number of patients, three of the ideal group experienced either minor or major complications, as compared to six in the overweight group; 10 in the obese group; eight in the morbidly obese group; and 22 in the severely morbidly obese group.

A statistically significant association was found between increasing BMI and an increased number of complications and poorer outcomes.  Specifically, the percentage of complication increased as weight category increased.  Minor complications increased from 3.3% in the ideal weight group to 46.9% in the severely morbidly obese group; major complications increased from 6.6% in the ideal weight group to 43.7% in the severely morbidly obese group.

An increasing number of patients are seeking out body contouring procedures such as thigh, buttock or upper arm lifts. According to ASAPS statistics, 368,313 body contouring procedures were performed in 2007. 

“Because of rising demand for body contouring procedures, it is increasingly important for plastic surgeons to be cognizant of potential predictors of poor outcomes and/or complications that can arise as a result,” said Donald Mackay, MD, a board certified plastic surgeon at Penn States’ College of Medicine in Hershey, PA, and senior author of the study.  “Obesity is a significant risk factor when considering operative procedures, particularly due to secondary conditions, such as hypertension, diabetes, sleep apnea, cardiovascular disease, and poor healing, that generally accompany it.”

Very few studies have looked at complication occurrence and its relationship with increasing body mass index.

“These findings lay the groundwork for establishing evidence based medicine guidelines to better assist us in evaluating patients for potential risk when considering these increasingly popular procedures, and in weighing those risks against the potential benefits in our varied patients,” said Alan H. Gold, MD, President of ASAPS.  “It is our responsibility as plastic surgeons to do everything possible to ensure the best and safest results for our patients.”

About ASAPS
The American Society for Aesthetic Plastic Surgery, the leading organization of board-certified plastic surgeons specializing in cosmetic plastic surgery. ASAPS active-member plastic surgeons are certified by the American Board of Plastic Surgery or the Royal College of Physicians and Surgeons of Canada. 

SOURCE: ASAPS