Relationship of obesity and specimen weight to complications in reduction mammaplasty.

Abstract:

:Obesity and specimen weight have both been associated with a higher incidence of complications for patients undergoing reduction mammaplasty. However, obesity has been arbitrarily and inconsistently defined, and the degree of obesity has not been considered in these previous studies. Because insurance companies are increasingly demanding weight loss before authorizing surgery, the relationship of obesity and breast size to complications is of great importance. Upon critical review of the literature, a number of fundamental questions remain unanswered. If complications are more frequent in the obese patient, are these complications directly proportional to the degree of obesity? Also, if the patient is required to lose weight before surgery, is weight loss effective in reducing complication rates? In an attempt to clarify these issues, 395 patients who underwent reduction mammaplasty over a 10-year period were reviewed retrospectively. Patients were arbitrarily divided into five groups in which, depending on their degree of relative obesity, they were classified as less than 5 percent, 5 to 10 percent, 10 to 15 percent, 15 to 20 percent, or greater than 20 percent above average body weight. To evaluate the relationship of specimen weight to complications, patients were also arbitrarily divided into five groups according to weight of the breast reduction specimen, which was classified as less than 300 g, 300 to 600 g, 600 to 900 g, 900 to 1200 g, and greater than 1200 g reduction per breast. Complications were then divided into local and systemic and major and minor. When bilateral reductions alone were analyzed (n = 267), there was a statistically significant increase in complication rate in the obese (p = 0.01). However, when the obese population was further subdivided according to their degree of obesity (less than 5 percent, 5 to 10 percent, 10 to 15 percent, 15 to 20 percent, and greater than 20 percent above average body weight), no further correlation was found. However, the relationship between specimen weight per breast and complications was much stronger with a direct correlation existing between increasing specimen weight and the incidence of complications. Although this study has shown that patients who are average body weight have fewer complications than obese patients after breast reduction surgery, it has not shown an increasing incidence of complication with increasing degrees of obesity. The implications of these findings and their relationship for denying patients surgery on the basis of weight alone are discussed in detail.

journal_name

Plast Reconstr Surg

authors

Zubowski R,Zins JE,Foray-Kaplon A,Yetman RJ,Lucas AR,Papay FA,Heil D,Hutton D

doi

10.1097/00006534-200010000-00006

subject

Has Abstract

pub_date

2000-10-01 00:00:00

pages

998-1003

issue

5

eissn

0032-1052

issn

1529-4242

journal_volume

106

pub_type

杂志文章
  • Spinal cord stimulation improves survival in ischemic skin flaps: an experimental study of the possible mediation by calcitonin gene-related peptide.

    abstract::Currently, spinal cord stimulation is used to treat ischemia and ischemic pain, with the best results observed in vasospastic cases. It was earlier demonstrated that spinal cord stimulation may attenuate experimentally induced vasospasm in an island flap in the rat. The present study was designed to investigate whethe...

    journal_title:Plastic and reconstructive surgery

    pub_type: 杂志文章

    doi:10.1097/00006534-199904040-00018

    authors: Gherardini G,Lundeberg T,Cui JG,Eriksson SV,Trubek S,Linderoth B

    更新日期:1999-04-01 00:00:00

  • Vascular anatomy of the upper extremity muscles.

    abstract::This study delineates the vascular anatomy of the upper extremity with particular attention toward the size, location, and number of vascular pedicles supplying each muscle. Ten cadaver upper extremities were dissected. A total of 440 muscles and 2209 pedicles were identified. The major "named" arterial source, number...

    journal_title:Plastic and reconstructive surgery

    pub_type: 杂志文章

    doi:10.1097/00006534-198803000-00007

    authors: Parry SW,Ward JW,Mathes SJ

    更新日期:1988-03-01 00:00:00

  • Sagittal craniosynostosis outcome assessment for two methods and timings of intervention.

    abstract::A retrospective quantitative analysis of 40 infants who underwent surgery for sagittal craniosynostosis was conducted to determine whether any difference in outcome, with respect to cranial index (cranial width/cranial length x 100), could be associated with either the age at surgery or the extent of the operation. Ch...

    journal_title:Plastic and reconstructive surgery

    pub_type: 杂志文章

    doi:10.1097/00006534-199905060-00004

    authors: Panchal J,Marsh JL,Park TS,Kaufman B,Pilgram T,Huang SH

    更新日期:1999-05-01 00:00:00

  • Application of the dorsal metacarpal artery perforator flap for resurfacing soft-tissue defects proximal to the fingertip.

    abstract:BACKGROUND:The dorsal metacarpal artery perforator flap is a versatile solution for resurfacing soft-tissue defects of fingers. The authors present their experience in applying this flap for a variety of finger wounds for which conventional means may not be amenable. METHODS:Fifty-eight dorsal metacarpal artery perfor...

    journal_title:Plastic and reconstructive surgery

    pub_type: 杂志文章

    doi:10.1097/PRS.0b013e318221ddfa

    authors: Sebastin SJ,Mendoza RT,Chong AKS,Peng YP,Ono S,Chung KC,Lim AYT

    更新日期:2011-09-01 00:00:00

  • Aesthetic management of the nasal component of naso-orbital ethmoid fractures.

    abstract:LEARNING OBJECTIVES:After studying this article, the participant should be able to: 1. Discuss the critical anatomic structures of the nose that are affected in naso-orbital ethmoid fractures. 2. Discuss the advantages of early, complete nasal reconstruction of these fractures. 3. Apply a clinical algorithm to such nas...

    journal_title:Plastic and reconstructive surgery

    pub_type: 杂志文章

    doi:10.1097/01.prs.0000195081.39771.57

    authors: Potter JK,Muzaffar AR,Ellis E,Rohrich RJ,Hackney FL

    更新日期:2006-01-01 00:00:00

  • Relevant Surgical Anatomy of Pterygomaxillary Dysjunction in Le Fort III Osteotomy.

    abstract:BACKGROUND:Le Fort III osteotomy represents the foundation of surgical correction for midface hypoplasia. One serious complication of Le Fort III osteotomy is severing the internal maxillary artery or its branches during osteotome advancement for pterygomaxillary dysjunction. This study sought to characterize the relev...

    journal_title:Plastic and reconstructive surgery

    pub_type: 杂志文章

    doi:10.1097/PRS.0000000000003084

    authors: Orra S,Tierney WS,Capone AC,Gharb BB,Papay FA,Doumit G

    更新日期:2017-03-01 00:00:00

  • Airway and Feeding Outcomes of Mandibular Distraction, Tongue-Lip Adhesion, and Conservative Management in Pierre Robin Sequence: A Prospective Study.

    abstract:BACKGROUND:Pierre Robin sequence is characterized by mandibular retrognathia and glossoptosis resulting in airway obstruction and feeding difficulties. When conservative management fails, mandibular distraction osteogenesis or tongue-lip adhesion may be required to avoid tracheostomy. The authors' goal was to prospecti...

    journal_title:Plastic and reconstructive surgery

    pub_type: 杂志文章

    doi:10.1097/PRS.0000000000003167

    authors: Khansa I,Hall C,Madhoun LL,Splaingard M,Baylis A,Kirschner RE,Pearson GD

    更新日期:2017-04-01 00:00:00

  • Histologic structure of human costochondral junction.

    abstract::Costochondral grafts are commonly used to restore dysplastic mandibular condyles. Despite their worldwide use, the growth of the condyle-ramus unit constructed with a costochondral graft is highly unpredictable, excess growth being the most common consequential problem. In a recent series of experiments on rats, it be...

    journal_title:Plastic and reconstructive surgery

    pub_type: 杂志文章

    doi:10.1097/00006534-199410000-00003

    authors: Peltomäki T

    更新日期:1994-10-01 00:00:00

  • Nasal trauma and the deviated nose.

    abstract::As the most prominent facial feature, the nose carries an increased risk of traumatic injury. Nasal fracture is the most common bone injury of the adult face and frequently results from motor vehicle accidents, sports-related injuries, and altercations. Although often initially considered minor, nasal fracture may eve...

    journal_title:Plastic and reconstructive surgery

    pub_type: 杂志文章,评审

    doi:10.1097/01.prs.0000260722.91183.50

    authors: Higuera S,Lee EI,Cole P,Hollier LH Jr,Stal S

    更新日期:2007-12-01 00:00:00

  • Separation of Craniopagus Twins over the Past 20 Years: A Systematic Review of the Variables That Lead to Successful Separation.

    abstract:BACKGROUND:Attempted separation of craniopagus twins has continued to be associated with devastating results since the first partially successful separation with one surviving twin in 1952. To understand the factors that contribute to successful separation in the modern era of neuroimaging and modern surgical technique...

    journal_title:Plastic and reconstructive surgery

    pub_type: 杂志文章,评审

    doi:10.1097/PRS.0000000000002269

    authors: Harvey DJ,Totonchi A,Gosain AK

    更新日期:2016-07-01 00:00:00

  • Boomerang pattern correction of gynecomastia.

    abstract:BACKGROUND:After excess skin and fat are removed, a body-lift suture advances skin and suspends ptotic breasts, the mons pubis, and buttocks. For women, the lift includes sculpturing adiposity. While some excess fat may need removal, muscular men should receive a deliberate effort to achieve generalized tight skin clos...

    journal_title:Plastic and reconstructive surgery

    pub_type: 杂志文章

    doi:10.1097/PRS.0000000000000933

    authors: Hurwitz DJ

    更新日期:2015-02-01 00:00:00

  • Teaching plastic surgery from different perspectives.

    abstract::Just as everyone has a different learning style, teachers too approach the task from different perspectives. There are five basic teaching perspectives or styles: transmission, apprenticeship, developmental, nurturing, and social justice. The acronym BIAS is useful to describe the beliefs, intentions, assessments, and...

    journal_title:Plastic and reconstructive surgery

    pub_type: 杂志文章

    doi:10.1097/PRS.0b013e318252f182

    authors: Cable C,Chong T,Pratt DD

    更新日期:2012-06-01 00:00:00

  • MOC-PS(SM) CME article: breast augmentation.

    abstract:LEARNING OBJECTIVES:After studying this article, the participant should be able to: 1. Evaluate patients seeking breast augmentation using key variables to assist in selection from the choices for incision, implant type and size, and plane of dissection. 2. Minimize the need for revisionary surgery to factors beyond th...

    journal_title:Plastic and reconstructive surgery

    pub_type: 杂志文章,评审

    doi:10.1097/01.prs.0000305933.31540.5d

    authors: Alpert BS,Lalonde DH

    更新日期:2008-04-01 00:00:00

  • The effect of muscle transplantation after unilateral partial facial paralysis on craniofacial growth and development: relationship between muscle and nerve histomorphometric findings.

    abstract::Muscle transplantation has become an indispensable tool to restore the smile in patients with long-standing or congenital facial paralysis. However, little is known of the effect of this surgical intervention on craniofacial growth and development or of the adaptation of the transplant to its recipient site under circ...

    journal_title:Plastic and reconstructive surgery

    pub_type: 杂志文章

    doi:10.1097/00006534-200001000-00020

    authors: Sinsel NK,Guelinckx PJ,Opdebeeck H

    更新日期:2000-01-01 00:00:00

  • Lymphaticovenular bypass for lymphedema management in breast cancer patients: a prospective study.

    abstract:BACKGROUND:Lymphedema is a common and debilitating condition. Management options for lymphedema are limited and controversial. The purpose of this prospective study was to provide a preliminary analysis of lymphaticovenular bypass for the treatment of upper limb lymphedema in breast cancer patients. METHODS:Twenty pat...

    journal_title:Plastic and reconstructive surgery

    pub_type: 杂志文章

    doi:10.1097/PRS.0b013e3181e5f6a9

    authors: Chang DW

    更新日期:2010-09-01 00:00:00

  • Breast reconstruction after mastectomy using the temporary expander.

    abstract::Breast reconstruction after a radical mastectomy using the temporary subcutaneous tissue expander is described. The main principle of this method is recovery of the amount of lost tissue through expansion of the remaining chest skin to large proportions and filling of the breast envelope with a smaller permanent mamma...

    journal_title:Plastic and reconstructive surgery

    pub_type: 杂志文章

    doi:10.1097/00006534-198202000-00001

    authors: Radovan C

    更新日期:1982-02-01 00:00:00

  • Heel coverage with a T-shaped distally based sural island fasciocutaneous flap.

    abstract::Two cases of heel damage that were reconstructed with a T-shaped distally based island fasciocutaneous flap in the sural area are presented. This flap is vascularized by the distal sural arterial network. The advantages of this flap are: (1) It does not sacrifice any major arteries of the leg. (2) It covers the whole ...

    journal_title:Plastic and reconstructive surgery

    pub_type: 杂志文章

    doi:10.1097/00006534-199404000-00036

    authors: Hyakusoku H,Tonegawa H,Fumiiri M

    更新日期:1994-04-01 00:00:00

  • A fresh cadaveric study of the paratubal muscles: implications for eustachian tube function in cleft palate.

    abstract::The aims of this anatomic investigation were to examine the levator veli palatini, tensor veli palatini, and salpingopharyngeus muscles in relation to normal eustachian tube function and to analyze the clinical implications of these data for tubal physiology in cleft palate individuals. Detailed dissections under 3.2x...

    journal_title:Plastic and reconstructive surgery

    pub_type: 杂志文章

    doi:10.1097/00006534-199709001-00003

    authors: Huang MH,Lee ST,Rajendran K

    更新日期:1997-09-01 00:00:00

  • The usability of the upper eyelid crease approach for correction of medial orbital wall blowout fracture.

    abstract:BACKGROUND:There are many approaches to the medial orbital wall. However, most of them have problems with limitation of exposure, scarring, and postoperative inflammatory symptoms related to the eye. The authors used an upper eyelid crease approach to overcome these problems and investigate the usefulness of this appro...

    journal_title:Plastic and reconstructive surgery

    pub_type: 杂志文章

    doi:10.1097/PRS.0b013e318262f3d9

    authors: Kim HS,Kim SE,Evans GRD,Park SH

    更新日期:2012-10-01 00:00:00

  • Pearls and perils of caring for the postbariatric body contouring patient.

    abstract::Postbariatric body contouring surgery has grown in prevalence, mirroring the ascent of weight loss surgery. With the rise in prevalence of this subset of plastic surgery procedures, we are gaining wisdom about technique, safety, and outcomes associated with this patient population. The pearls of patient management inc...

    journal_title:Plastic and reconstructive surgery

    pub_type: 杂志文章,评审

    doi:10.1097/PRS.0b013e318262f545

    authors: Shermak MA

    更新日期:2012-10-01 00:00:00

  • Carpal tunnel release through a limited skin incision under direct visualization using a new instrument, the carposcope.

    abstract::A new surgical technique with a set of instruments has been developed for the release of carpal tunnel. The technique allows division of the transverse carpal ligament through a short transverse skin incision (1.5 to 2 cm) of the wrist flexion crease under direct visualization. The technique has been used on 237 patie...

    journal_title:Plastic and reconstructive surgery

    pub_type: 杂志文章

    doi:10.1097/00006534-199608000-00016

    authors: Lee H,Jackson TA

    更新日期:1996-08-01 00:00:00

  • Animal-based hyaluronic acid fillers: scientific and technical considerations.

    abstract:BACKGROUND:Successful clinical application of dermal filler products requires an understanding of their physical characteristics and in vivo behavior. This study reviewed the data for hyaluronic acid dermal filler products derived from an animal source--the rooster comb. METHODS:A review of the hyaluronic acid literat...

    journal_title:Plastic and reconstructive surgery

    pub_type: 杂志文章

    doi:10.1097/01.prs.0000248806.70402.7b

    authors: Clark CP 3rd

    更新日期:2007-11-01 00:00:00

  • Perforator flap breast reconstruction using internal mammary perforator branches as a recipient site: an anatomical and clinical analysis.

    abstract::A variety of useful recipient sites exist for breast reconstruction with free flaps, and correct selection remains a significant decision for the surgeon. Among the main pedicles, the disadvantages of the internal mammary vessels are the necessity of costal cartilage resection and the impairment of future cardiac bypa...

    journal_title:Plastic and reconstructive surgery

    pub_type: 杂志文章

    doi:10.1097/01.prs.0000129074.88594.d7

    authors: Munhoz AM,Ishida LH,Montag E,Sturtz GP,Saito FL,Rodrigues L,Gemperli R,Ferreira MC

    更新日期:2004-07-01 00:00:00

  • Evaluation of autogenous tissue breast reconstruction using MRI.

    abstract::Recent controversy encountered with silicone breast implants has increased the use of autogenous tissue for breast reconstruction following mastectomy. Surveillance of patients who have undergone autogenous tissue reconstruction is important in the evaluation of recurrent or new cancer. Magnetic resonance imaging (MRI...

    journal_title:Plastic and reconstructive surgery

    pub_type: 杂志文章

    doi:10.1097/00006534-199501000-00010

    authors: Ahn CY,Narayanan K,Gorczyca DP,DeBruhl ND,Shaw WW

    更新日期:1995-01-01 00:00:00

  • Airway hazards associated with pharyngeal flaps in patients who have the Pierre Robin syndrome.

    abstract::We describe 3 patients with the Pierre Robin Syndrome who developed severe problems of airway obstruction after having the cleft palate closed and a pharyngeal flap done simultaneously. We now believe that, even at a later age, pharyngeal flaps should be done in these patients only after a most careful assessment of t...

    journal_title:Plastic and reconstructive surgery

    pub_type: 杂志文章

    doi:10.1097/00006534-197608000-00007

    authors: Jackson P,Whitaker LA,Randall P

    更新日期:1976-08-01 00:00:00

  • A primer of schematics to facilitate the design of the preferred muscle perforator flaps.

    abstract:BACKGROUND:The universal adoption of muscle perforator flaps has been hampered by a lack of uniformity that would ensure the reliable harvest of the requisite vascular pedicle. Anatomical anomalies of their vascular supply are the anticipated norm, creating a conundrum inasmuch as retention of an adequate circulation i...

    journal_title:Plastic and reconstructive surgery

    pub_type: 杂志文章

    doi:10.1097/PRS.0b013e318199f7d2

    authors: Hallock GG

    更新日期:2009-03-01 00:00:00

  • Endoscopic excision and repair of simulated bilateral cleft lips in fetal lambs.

    abstract::The use of nonpenetrating clips to accomplish wound closure as an alternative to suture in the repair of simulated cleft lips in partially exteriorized fetuses has been described previously. In this study, the fetus is approached endoscopically, and clipped (n = 8) and sutured (n = 4) intrauterine endoscopic repairs i...

    journal_title:Plastic and reconstructive surgery

    pub_type: 杂志文章

    doi:10.1097/00006534-199807000-00001

    authors: Oberg KC,Robles AE,Ducsay C,Childers B,Rasi CR,Gates DL,Kirsch WM,Hardesty RA

    更新日期:1998-07-01 00:00:00

  • A study of the supraorbital nerve.

    abstract::A detailed description of the anatomical relationships of the supraorbital nerve as it courses across the forehead and under the scalp cannot be found in most anatomy textbooks, and illustrations of the nerve beyond the superior orbital rim frequently misrepresent its course. Because the supraorbital nerve is a struct...

    journal_title:Plastic and reconstructive surgery

    pub_type: 杂志文章

    doi:10.1097/00006534-199509000-00007

    authors: Knize DM

    更新日期:1995-09-01 00:00:00

  • Application of high-tech three-dimensional imaging and computer-generated models in complex facial reconstructions with vascularized bone grafts.

    abstract::We present a series of six patients with eight flaps in whom computer-generated models were used for fabrication of vascularized bone grafts in complex facial restorations. Preoperative CT data, digitalized on tape, were converted by the CEMAX (Santa Clara, Calif.) 1500 Integrated Hardware and Software System to a thr...

    journal_title:Plastic and reconstructive surgery

    pub_type: 杂志文章

    doi:10.1097/00006534-199302000-00007

    authors: Rose EH,Norris MS,Rosen JM

    更新日期:1993-02-01 00:00:00

  • Comparison of the efficacy of hard palate grafts with acellular human dermis grafts in lower eyelid surgery.

    abstract:BACKGROUND:The Madame Butterfly procedure of lower eyelid reconstruction addresses lower eyelid retraction after blepharoplasty caused by middle lamellar tethering. After scar lysis and subperiosteal midface lift, the surgical procedure uses a lower eyelid spacer graft to prevent further postoperative contraction of th...

    journal_title:Plastic and reconstructive surgery

    pub_type: 杂志文章

    doi:10.1097/01.prs.0000177694.39466.b2

    authors: Li TG,Shorr N,Goldberg RA

    更新日期:2005-09-01 00:00:00