American Association of Plastic Surgeons

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Complication Rates Following Body Contouring Procedures: An Analysis Using Micronutrient Status
Hannah Soltani, BA1, Kathryn Reisner, BS2, Sophia Allison, BA1, Umer Qureshi, MEd2, Taylor Hallman, BS2, Rachel Donaldson, BS2, Emily Chwa, BA1, Arun K. Gosain, MD2
1Northwestern University Feinberg School of Medicine, Chicago, IL, USA, 2Division of Plastic Surgery, Ann and Robert H. Lurie Children’s Hospital, Chicago, IL, USA

PURPOSE:Previous studies have shown that patients who undergo bariatric surgery have an increased occurrence of complications following body contouring procedures. Nutrient deficiencies, including fat-soluble vitamins, vitamin B12, thiamine, and folate, are common for post-bariatric patients. We compared postoperative complication rates in nutrient-deficient vs. nutrient-sufficient post-bariatric patients undergoing body contouring procedures.
METHODS:This study was a retrospective review examining patients aged 18 years or older, who had undergone bariatric surgery with a subsequent body contouring procedure identified via CPT codes at our institution within the past 10 years. Micronutrient deficiencies were identified by new onset of abnormal lab values following bariatric surgery. Complications were recorded and chi-squared analyses were performed.
RESULTS:202 patients (89% F; 11% M) underwent either gastric bypass (52%), sleeve gastrectomy (38%), or another type of bariatric surgery procedure (10%). Subsequently, the patients underwent the following procedures: panniculectomy (66%), breast reduction (11%), mastopexy (10%), brachioplasty (8%), and lipectomy (2%). 174 (84.1%) patients had one or more reported post-operative deficiency. The most common deficiencies were vitamin D (57.5%), iron (33.3%), and vitamin B12 (14.4%). Thiamine-deficient post-bariatric patients were more likely to have a complication (p = 0.0353). Specifically, thiamine-deficient and hypoalbuminemic patients had significantly higher rates of hematomas (p = 0.002 and p = 0.0069 respectively).CONCLUSION:Patients undergoing body contouring procedures following bariatric surgery are most commonly found to have vitamin D deficiency and iron deficiency. Complication rates were highest in thiamine-deficient and hypoalbuminemic patients. This study prompts further research regarding optimal nutritional states for post-bariatric patients undergoing body contouring procedures.
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