Personal Evolution in Thighplasty Techniques for Patients Following Massive Weight Loss

Shelly M. Xie, Kevin Small, Ran Stark, Ryan S. Constantine, Jordan P. Farkas, Jeffrey M. Kenkel

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

Background Lockwood described the importance of Colles' fascia anchoring in medial thighplasty to reduce morbidity associated with the procedure. However, this maneuver may still have complications including traumatic dissection, prolonged edema, and potential wound healing ramifications form increased tension. Alternatively, we suggest orienting tension in medial thighplasty for massive weight loss (MWL) patients in the horizontal vector rather than a vertical direction, negating the need for Colles' fascia anchoring. Objectives To compare the morbidities, complications, and outcomes between Colles' fascia suture fixation (CFSF) and horizontal vector fixation (HVF) in medial thighplasties in MWL patients. Methods A retrospective chart review was conducted on an Institutional Review Board approved database of MWL patients who had medial thighplasty between October 2004 and March 2014. Patient demographics and surgical outcomes were reviewed between those MWL patients with CFSF and HVF. Results Of 65 post-MWL patients, 26 (40.0%) patients were in the CFSF group, and 39 (60.0%) patients were in the HVF group. The 2 groups had statistically equivocal preoperative characteristics and comorbidities. Intraoperatively, the HVF group had increased use of barbed suture (92.3% vs 30.6%, P < 0.0001) and liposuction (71.8% vs 26.9%, P < 0.0001). Postoperatively, the HVF group had decreased incidence of infection (5.1% vs 23.0%, P = 0.051) and lymphocele/seroma (10.3% vs 34.6%, P = 0.0257). No statistical differences were observed for dehiscence, necrosis, or hematoma. Conclusions HVF for medial thighplasty in MWL patients is a safe and effective procedure, with a lower complication profile than CFSF. Furthermore, the incorporation of barbed sutures and/or liposuction may help to achieve optimal results. Level of Evidence: 3

Original languageEnglish (US)
Pages (from-to)1124-1135
Number of pages12
JournalAesthetic Surgery Journal
Volume37
Issue number10
DOIs
StatePublished - Nov 1 2017

Fingerprint

Weight Loss
Fascia
Sutures
Lipectomy
Lymphocele
Morbidity
Seroma
Research Ethics Committees
Hematoma
Wound Healing
Dissection
Comorbidity
Edema
Necrosis
Demography
Databases
Incidence
Infection

ASJC Scopus subject areas

  • Surgery

Cite this

Personal Evolution in Thighplasty Techniques for Patients Following Massive Weight Loss. / Xie, Shelly M.; Small, Kevin; Stark, Ran; Constantine, Ryan S.; Farkas, Jordan P.; Kenkel, Jeffrey M.

In: Aesthetic Surgery Journal, Vol. 37, No. 10, 01.11.2017, p. 1124-1135.

Research output: Contribution to journalArticle

Xie, Shelly M. ; Small, Kevin ; Stark, Ran ; Constantine, Ryan S. ; Farkas, Jordan P. ; Kenkel, Jeffrey M. / Personal Evolution in Thighplasty Techniques for Patients Following Massive Weight Loss. In: Aesthetic Surgery Journal. 2017 ; Vol. 37, No. 10. pp. 1124-1135.
@article{5b3c4c8040044e488d5f0cd3d5c96a6e,
title = "Personal Evolution in Thighplasty Techniques for Patients Following Massive Weight Loss",
abstract = "Background Lockwood described the importance of Colles' fascia anchoring in medial thighplasty to reduce morbidity associated with the procedure. However, this maneuver may still have complications including traumatic dissection, prolonged edema, and potential wound healing ramifications form increased tension. Alternatively, we suggest orienting tension in medial thighplasty for massive weight loss (MWL) patients in the horizontal vector rather than a vertical direction, negating the need for Colles' fascia anchoring. Objectives To compare the morbidities, complications, and outcomes between Colles' fascia suture fixation (CFSF) and horizontal vector fixation (HVF) in medial thighplasties in MWL patients. Methods A retrospective chart review was conducted on an Institutional Review Board approved database of MWL patients who had medial thighplasty between October 2004 and March 2014. Patient demographics and surgical outcomes were reviewed between those MWL patients with CFSF and HVF. Results Of 65 post-MWL patients, 26 (40.0{\%}) patients were in the CFSF group, and 39 (60.0{\%}) patients were in the HVF group. The 2 groups had statistically equivocal preoperative characteristics and comorbidities. Intraoperatively, the HVF group had increased use of barbed suture (92.3{\%} vs 30.6{\%}, P < 0.0001) and liposuction (71.8{\%} vs 26.9{\%}, P < 0.0001). Postoperatively, the HVF group had decreased incidence of infection (5.1{\%} vs 23.0{\%}, P = 0.051) and lymphocele/seroma (10.3{\%} vs 34.6{\%}, P = 0.0257). No statistical differences were observed for dehiscence, necrosis, or hematoma. Conclusions HVF for medial thighplasty in MWL patients is a safe and effective procedure, with a lower complication profile than CFSF. Furthermore, the incorporation of barbed sutures and/or liposuction may help to achieve optimal results. Level of Evidence: 3",
author = "Xie, {Shelly M.} and Kevin Small and Ran Stark and Constantine, {Ryan S.} and Farkas, {Jordan P.} and Kenkel, {Jeffrey M.}",
year = "2017",
month = "11",
day = "1",
doi = "10.1093/asj/sjx060",
language = "English (US)",
volume = "37",
pages = "1124--1135",
journal = "Aesthetic Surgery Journal",
issn = "1090-820X",
publisher = "SAGE Publications Inc.",
number = "10",

}

TY - JOUR

T1 - Personal Evolution in Thighplasty Techniques for Patients Following Massive Weight Loss

AU - Xie, Shelly M.

AU - Small, Kevin

AU - Stark, Ran

AU - Constantine, Ryan S.

AU - Farkas, Jordan P.

AU - Kenkel, Jeffrey M.

PY - 2017/11/1

Y1 - 2017/11/1

N2 - Background Lockwood described the importance of Colles' fascia anchoring in medial thighplasty to reduce morbidity associated with the procedure. However, this maneuver may still have complications including traumatic dissection, prolonged edema, and potential wound healing ramifications form increased tension. Alternatively, we suggest orienting tension in medial thighplasty for massive weight loss (MWL) patients in the horizontal vector rather than a vertical direction, negating the need for Colles' fascia anchoring. Objectives To compare the morbidities, complications, and outcomes between Colles' fascia suture fixation (CFSF) and horizontal vector fixation (HVF) in medial thighplasties in MWL patients. Methods A retrospective chart review was conducted on an Institutional Review Board approved database of MWL patients who had medial thighplasty between October 2004 and March 2014. Patient demographics and surgical outcomes were reviewed between those MWL patients with CFSF and HVF. Results Of 65 post-MWL patients, 26 (40.0%) patients were in the CFSF group, and 39 (60.0%) patients were in the HVF group. The 2 groups had statistically equivocal preoperative characteristics and comorbidities. Intraoperatively, the HVF group had increased use of barbed suture (92.3% vs 30.6%, P < 0.0001) and liposuction (71.8% vs 26.9%, P < 0.0001). Postoperatively, the HVF group had decreased incidence of infection (5.1% vs 23.0%, P = 0.051) and lymphocele/seroma (10.3% vs 34.6%, P = 0.0257). No statistical differences were observed for dehiscence, necrosis, or hematoma. Conclusions HVF for medial thighplasty in MWL patients is a safe and effective procedure, with a lower complication profile than CFSF. Furthermore, the incorporation of barbed sutures and/or liposuction may help to achieve optimal results. Level of Evidence: 3

AB - Background Lockwood described the importance of Colles' fascia anchoring in medial thighplasty to reduce morbidity associated with the procedure. However, this maneuver may still have complications including traumatic dissection, prolonged edema, and potential wound healing ramifications form increased tension. Alternatively, we suggest orienting tension in medial thighplasty for massive weight loss (MWL) patients in the horizontal vector rather than a vertical direction, negating the need for Colles' fascia anchoring. Objectives To compare the morbidities, complications, and outcomes between Colles' fascia suture fixation (CFSF) and horizontal vector fixation (HVF) in medial thighplasties in MWL patients. Methods A retrospective chart review was conducted on an Institutional Review Board approved database of MWL patients who had medial thighplasty between October 2004 and March 2014. Patient demographics and surgical outcomes were reviewed between those MWL patients with CFSF and HVF. Results Of 65 post-MWL patients, 26 (40.0%) patients were in the CFSF group, and 39 (60.0%) patients were in the HVF group. The 2 groups had statistically equivocal preoperative characteristics and comorbidities. Intraoperatively, the HVF group had increased use of barbed suture (92.3% vs 30.6%, P < 0.0001) and liposuction (71.8% vs 26.9%, P < 0.0001). Postoperatively, the HVF group had decreased incidence of infection (5.1% vs 23.0%, P = 0.051) and lymphocele/seroma (10.3% vs 34.6%, P = 0.0257). No statistical differences were observed for dehiscence, necrosis, or hematoma. Conclusions HVF for medial thighplasty in MWL patients is a safe and effective procedure, with a lower complication profile than CFSF. Furthermore, the incorporation of barbed sutures and/or liposuction may help to achieve optimal results. Level of Evidence: 3

UR - http://www.scopus.com/inward/record.url?scp=85032037466&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85032037466&partnerID=8YFLogxK

U2 - 10.1093/asj/sjx060

DO - 10.1093/asj/sjx060

M3 - Article

C2 - 29044362

AN - SCOPUS:85032037466

VL - 37

SP - 1124

EP - 1135

JO - Aesthetic Surgery Journal

JF - Aesthetic Surgery Journal

SN - 1090-820X

IS - 10

ER -