Effects of Comorbidities on Outcomes in the Upper Body Lift

Goals/Purpose: Nonsurgical and surgical weight loss options have improved over the past several decades resulting in an increased number of patients who present with body contour deformities. This review focuses on the upper truncal deformity. This deformity is discernable by its residual tissue laxity in the upper arm, back, lateral chest, and breast. The purpose of this study is to evaluate the morbidity of this procedure when these regions are treated in one operative setting.

Methods/Technique: A retrospective chart review of patients who underwent an upper body lift for truncal deformities after massive weight loss by the senior author between August 2006 and December 2019 was performed. Patient comorbidities and demographics preoperative parameters, operative factors, and minor and major complications were assessed.

Results/Complications: No intraoperative or major complications occurred. The overall complication rate was 71% (20/28), which were all minor and most related to wound breakdown. Seven patients required revisionary surgery, most commonly scar revision secondary to difficulties with wound healing. On Chi-squared analysis, there was a statistically significant positive correlation between ASA status and smoking. Simple Matching Coefficients (SMC) analysis identified, celecoxib use, HTN, smoking status, and anemia to be highly correlated with any adverse outcome. Finally, logistic regression of weight resected and outcomes as well as BMI and outcomes showed no statistical significance.

Conclusion: This series helps define the role of upper body lift in the care of patients with massive weight loss and addresses the morbidity of a comprehensive approach to the upper body deformity. Appropriate patient selection, preoperative patient counseling, sound operative technique, and adherence to postoperative care can help to avoid adverse outcomes.