الفهرس | Only 14 pages are availabe for public view |
Abstract The number of patients demanding plastic surgery correction of contour abnormalities has increased with the advancement in weight loss procedures. Massive weight-loss patients often present a circumferential truncal skin and subcutaneous tissue redundancy, which cannot be optimally corrected by common abdominoplasty techniques. Circumferential abdominoplasty, belt lipectomy, 360° abdominoplasty, and lower body lift are all synonyms of a body contouring procedure with the aim of sculpting the torso, modifying abdominal contour, loins and lower back contours. Despite growing number of published literature that supports the efficacy of circumferential abdominoplasty for post-bariatric body contouring, there is, still, a scarcity in high-level evidence that assesses the safety and efficacy of circumferential abdominoplasty. Thus, we conducted the present systematic review and meta-analysis in order to summarize surgical indications, operative techniques, outcomes, complications of circumferential abdominoplasty procedures following bariatric surgery. In the present study, we searched Medline via PubMed, SCOPUS, Web of Science, and Cochrane Central Register of Controlled Trials (CENTRAL) from their inception till February 2019. The search retrieved 512 unique records. We then retained 89 potentially eligible records for full-texts screening. Finally, 26 studies (Total No. of patients =1234) were included in the present systematic review and meta-analysis. The present systematic review and meta-analysis showed that the average age of the patients within the included studies ranged from 28-45.2 years old; while the majority of those patients were females. In the present systematic review and meta-analysis, the majority of the included studies (No = 14 studies) utilized lower body lift technique; while six studies utilized belt lipoectomy. In the present systematic review and meta-analysis, we utilized patients’ satisfaction as the primary outcome for abdominoplasty effectiveness. Over all, eight studies reported the satisfaction rates after circumferential abdominoplasty, the overall effect estimates showed that the circumferential abdominoplasty achieved a satisfaction rate of 98% (95% CI [0.95.5 – 0.99.7). The overall effect showed that the average operative time of circumferential abdominoplasty was 278 minutes (95% CI 241 - 315). Similarly, overall effect showed that the hospital stay after circumferential abdominoplasty was 5.5 days (95% CI 1.45 - 9.52). In terms of complications, sixteen studies reported the rates of complications after circumferential abdominoplasty. The overall effect estimates showed that the rates of complications after circumferential abdominoplasty was 35% (95% CI 26 – 44%). In conclusion, circumferential abdominoplasty is safe and effective body-contouring procedure for post-bariatric patients. This procedure can be ethically proposed to patients with body-contour deformities following bariatric surgery, giving excellent results with minor morbidity. The present systematic review and meta-analysis showed that circumferential abdominoplasty achieved a satisfaction rate of 98% and lower hospital stay than classic abdominoplasty. In addition, the rate of serious postoperative complications was very low. However, special attention should be paid for postoperative seroma and wound dehiscence. |