One-Stage Combined Postbariatric Surgery: A Series of 248 Procedures in 55 Cases

Abstract

Introduction: Combined and/or multistage operations often are needed in postbariatric surgery. Aim: With this retrospective study of a series of 55 cases, we aim to determine the effectiveness and safety of one-stage combined postbariatric surgery. Materials and Methods: A total of 248 postbariatric procedures were performed in one session (except one-staged gynecomastia case) in 55 patients. The procedures included face and neck lifting, upper and lower trunk lifting, gluteal fat injection, mammoplasty, gynecomastia correction, abdominoplasty, and thigh and arm lifting. Sagged tissues of the trunk and extremities were removed by avulsing after tumescent liposuction. Liposuction was performed also on the neighboring tissues. Multilayer repair from superficial fascia to the skin was carried out after meticulous hemostasis and suction drain insertion. Results: At least two plastic surgeons and two assistants entered the operations, operation time never exceeded 4.5 h except in one, and blood transfusion was needed only in one case. All patients were discharged from the hospital after 1 or 2 nights. Postoperative problems included infection (3.64% of the patients), delayed wound healing after seroma formation (32.73%), abnormal scar formation (1.82%), and demanded scar revision and revisionary liposuction by 10 patients (18.18%). Conclusion: Combined postbariatric operations are very effective and the likelihood of serious complications could be decreased significantly when performed under certain conditions. The tumescent dermolipectomy method is a very useful method for these cases. Level of Evidence IV: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266. © 2019 Elsevier B.V., All rights reserved.