Objective. To compare the results of various brachioplasty options in patients after massive weight loss. Material and methods. The study included 97 patients after massive weight loss divided into two groups depending on extent of surgery: group 1 — 44 patients after excisional brachioplasty; group 2 — 53 patients after brachioplasty and liposuction of shoulders. The incidence of early (30 days after surgery) and late postoperative complications was assessed. Patient satisfaction with aesthetic and functional outcomes was assessed using subjective Likert scale. Results. In group 1, wound edge divergence (19.0% and 0%), seroma (19.0% and 0%) and hypertrophic scarring (28.6% and 4.3%) were significantly more common in grade 3 ptosis compared to grade 2 (p<0.05). In group 1, patients with grade 3 ptosis were more likely to have wound edge divergence (19.0% and 3.4%) and hypertrophic scarring (28.6% and 3.4%) compared to patients with grade 3 ptosis in group 2 (p<0.05). Positive ratings of shoulder contour and location of postoperative scars were more common among patients with grade 3 ptosis in group 2 compared to group 1 (48.3% and 19.0%, respectively; p<0.05). Conclusion. Brachioplasty is safe and effective for correction of shoulder deformities in patients with grade 2 and 3 ptosis after massive weight loss. In grade 3 ptosis, brachioplasty combined with liposuction contributes to significantly lower incidence of postoperative complications (wound edge divergence, seroma, hypertrophic scarring) and higher satisfaction with shoulder contour / location of postoperative scars after massive weight loss compared to excisional brachioplasty.
Dergabuzova et al. (Mon,) studied this question.