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Orgun et al. Regenerative mechanisms of adipose-derived stem cells

Figure 4: Patient presented at Figure 3, 2 years after surgery. From left to right: pre-operative frontal view, back view, left lateral view, right
lateral view

Table 2: Comparison between extended abdominoplasty sexual activity, hygiene, and it can frequently cause
technique and traditional torsoplasty recurrent bouts of infection.
Characteristics Extended abdominoplasty Torsoplasty
Excisedtissue, g 3,430 3,460.9 The post-bariatric patient represents a challenge
Blood loss, mL 628.6 1,085.4 for plastic surgeon. Although post-bariatric body-
Trasfusion rate, % 0 27.3 contouring procedures are generally associated with
Operation lenght 3 h 30 s 4 h 30 s high rates of patient satisfaction, the surgeon has to face
Hospitalization time, days 7.8 12.5 the negative impact of postoperative complications.
The post-bariatric surgery population appears to be at
Peri and postoperative bleeding led to three cases of higher risk compared to patients who are not obese. [14]
anaemia necessitating blood transfusions (14.3%) in
the second group; no blood transfusion was needed in Arthurs et al. [15] found that pre-panniculectomy BMI was
the first group. the most important factor that independently predicted
postoperative complications after a panniculectomy;
No other major complications occurred during the meaning that post-bariatric surgery population is at
postoperative period in both groups, there was no need higher risk compared to non-obese patients. Patients
to drain hematoma or seroma, patients were mobilized with a BMI greater than 25 kg/m are at nearly three
2
during the first postoperative day and were discharged times the risk of postoperative wound complications.
without drains. Other important risk factors for complications are
nutritional deficiencies, smoking, venous varicosities,
Only 5 cases of superficial cutaneous necrosis and poor quality orinelastic tissues.
occurred on the bisiliac suture line, 2 in the first group
and 3 in the second group, solved with local dressings To obtain the best outcomes, a comprehensive
in less than 3 weeks. perioperative approach is required. Proper patient
selection, carefully considered surgical timing and the
Patients were uniformly pleased with their results: 90% choice of the surgical technique are fundamental to
of them were very satisfied, whereas 10% graded their avoid complications.
results as satisfactory.
There are many anatomical regions that massive
DISCUSSION weight loss patients would like corrected: redundant
flank and abdomen, hip rolls, breasts, arms, buttocks
The National Institutes of Health Consensus and thigh ptosis. For this reason body contouring is
Conference stated in 1991 “only surgery has proven generally not considered as a single stage procedure.
effective over the long term for most patients with
clinically severe obesity”. This statement was confirmed Among all the body contouring procedures,
and updated in 2004, by the American Society for abdominoplasty has a crucial role in body image
Bariatric Surgery (recently renamed as the American recovery. But the results, even in the most extensive
Society for Metabolic and Bariatric Surgery). [13] The form of abdominoplasty are usually suboptimal
number of bariatric surgery procedures has increased because the back and lateral flank deformities are not
steadily since then and, as a result, the number of considered.
massive weight loss patients seeking body-contouring
procedures has considerably grown. The redundant To address the circumferential nature of the skin
excess skin interferes with fitting clothing, physical and excess in these patients, various surgical techniques
Plastic and Aesthetic Research ¦ Volume 4 ¦ April 21, 2017 61