Lipoabdominoplastik in der postbariatrischen Chirurgie: eine relevante Alternative zur Fleur-de-Lis-Abdominoplastik?

 

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Zusammenfassung

Hintergrund Die Anzahl an bariatrischen Operationen und somit auch die Anzahl an postbariatrischen Eingriffen ist in den letzten Jahren dramatisch gestiegen. Obwohl in der postbariatrischen Chirurgie lange Narbenverläufe zu Gunsten einer Körperformrekonstruktion üblich sind, beobachten wir neben dem Wunsch der Körperkonturierung zunehmend den nach ästhetisch ansprechenderen Ergebnissen. Insbesondere die Fleur-de-Lis-Abdominoplastik wird aufgrund der sichtbaren vertikalen Narbe von jungen Patientinnen nach massivem Gewichtsverlust kritisch gesehen. Häufig stören sich auch Operateure sowohl am ästhetischen Outcome wie auch an der höheren Komplikationsrate.

Methoden Retrospektive Analyse von 20 Patientinnen nach massivem Gewichtsverlust nach bariatrischer Operation, die im Zeitraum von Januar 2020 bis Januar 2021 statt einer Fleur-de-Lis Abdominoplastik eine Lipoabdominoplastik erhalten haben. Die Datenanalyse erfolgte anhand des präoperativen vertikalen und horizontalen Hautüberschüsse (Pittsburgh Rating Scale), anhand des Body-Mass-Index, der operativen Technik und des Endresultats.

Ergebnisse 20 Patientinnen mit einer Indikation zur Durchführung einer FdL-Abdominoplastik unterzogen sich einer kombinierten radikalen Liposuktion des Bauches mit traditioneller Abdominoplastik. Das Ursprungsgewicht vor der massiven Gewichtsreduktion rangierte zwischen 100–168 kg. Die durchschnittliche Gewichtsreduktion lag bei 56,5 kg. Im Mittel betrug der BMI 27,3 kg/m². Das Durchschnittsalter unserer Studiengruppe betrug 40 Jahre. Bei einer Patientin (5 %) konnte eine Major-Komplikation verzeichnet werden. Es handelte sich um ein infiziertes Serom, welches konservativ behandelt werden konnte. Eine Patientin (5 %) wünschte eine Nachstraffung in FDL-Technik im weiteren Verlauf.

Fazit Die Durchführung einer Lipoabdominoplastik ist auch bei postbariatrischen Patienten gut und sicher durchführbar. Es zeigen sich gute Körperkonturierungen ohne vertikale Schnittführung mit einem hohen Maß an Patientenzufriedenheit. Die Anzahl an Patienten, die sich einer FdL-Abdominoplastik unterziehen müssten, kann mit dieser Technik erfolgreich gesenkt werden.

Abstract

Background The number of bariatric procedures, and thus also the number of post-bariatric operations, has increased dramatically in recent years. Although long scars are common in post-bariatric surgery and accepted in favour of body shape reconstruction, we increasingly notice the wish for aesthetically pleasing results in addition to the desire for body contouring. In particular, Fleur-de-Lis abdominoplasty (FdL) is viewed critically by younger patients after massive weight loss due to the visible vertical scar. Surgeons are also often bothered by the unsatisfying aesthetic outcome as well as the higher rate of complications.

Methods Retrospective analysis of 20 female patients with massive weight loss following bariatric surgery, who received lipoabdominoplasty instead of Fleur-de-Lis abdominoplasty in the period from January 2019 to June 2020. Data analysis was based on measurements of preoperative vertical and horizontal excess skin and fat (Pittsburgh Rating Scale), Body Mass Index, surgical technique and final result.

Results Twenty female patients with an indication for FdL abdominoplasty underwent radical liposuction of the abdomen combined with abdominoplasty. The original weight before massive weight reduction ranged between 100 and 168 kg. Average weight reduction was 56.5 kg. The mean BMI was 27.3 kg/m². The average age of our cohort was 40 years. One patient (5 %) had a major complication. This was an infected seroma which could be treated conservatively. Two other patients (10 %) developed an uninfected seroma as a minor complication.

Conclusion Our work shows that lipoabdominoplasty can be performed safely and well even in patients after massive weight loss. It is possible to achieve good body contours without vertical incisions and with a high degree of patient satisfaction. The number of patients who have to undergo FdL abdominoplasty can be successfully reduced by this technique.

Publication History

Received: 27 September 2021

Accepted: 02 December 2021

Article published online:
13 April 2022

© 2022. Thieme. All rights reserved.

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

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