Evaluation of the Vertical Movement of Ribeiro’s Dermolipoglandular Mammary Flap One Year After Mammaplasties in Post-Bariatric Patients

2019 ◽  
Vol 40 (1) ◽  
pp. NP21-NP31 ◽  
Author(s):  
Rodrigo P Sizenando ◽  
Marco Túlio C Diniz ◽  
Paulo Roberto da Costa ◽  
Luiz Gustavo S Manhães
Keyword(s):  
Bariatric Surgery ◽  
Weight Loss ◽  
Plastic Surgery ◽  
Breast Tissue ◽  
Vertical Movement ◽  
Level Of Evidence ◽  
Significance Level ◽  
Areola Complex ◽  
Ptotic Breast ◽  
One Year

Abstract Background In 1971, Ribeiro isolated a segment in the inferior pole of the ptotic breast, nourished by muscular perforating vessels, and moved it cranially to the posterior region of the remaining detached breast tissue, where it was fixed to the pectoral fascia. This maneuver created a flap with autologous implant function, independent from the rest of the breast’s support, that maintained long-term mammary projection. Objectives The objectives of this study were to measure the vertical movement of this flap 1 year after mammaplasty and to evaluate the factors involved. Methods The sample included 13 patients who had previously undergone bariatric surgery. The position of a titanium marker attached to the Ribeiro flap was compared on chest radiographs taken 1 day and 1 year after the mammaplasty. The significance level was set at 5%. Results All of the titanium markers moved 0.6 cm to 4.1 cm caudally during the study period (average, 2.4 cm ± 1.02 cm). The greater the weight loss after the plastic surgery, the further the marker’s descent. Weight loss between bariatric surgery and plastic surgery, the vertical dimension of the ptotic breast tissue immediately before plastic surgery, the vertical extent of the nipple-areola complex elevation during mammaplasty, the Ribeiro flap thickness and volume, and the breast volume after mammaplasty were not associated with the vertical movement of the flap. Conclusions The Ribeiro flap employed in mammaplasty of patients who previously underwent bariatric surgery undergoes ptosis that is exacerbated by weight loss after mammaplasty. Level of Evidence: 4

scholarly journals Simultaneous Mastopexy Explantation With a Vertical Bipedicle and Novel Open Pattern Marking Technique

2021 ◽  
Vol 3 (1) ◽  
Author(s):  
Elliot M Hirsch
Keyword(s):  
Plastic Surgery ◽  
Breast Implant ◽  
Implant Removal ◽  
Consecutive Series ◽  
Level Of Evidence ◽  
Areola Complex ◽  
Depth Analysis ◽  
Safe Technique ◽  
Marking Technique ◽  
Technical Considerations

Abstract There are limited studies in the plastic surgery literature that detail technical considerations in simultaneous breast implant removal and mastopexy procedures. These procedures are difficult, with significant potential for complications and poor cosmesis. The current plastic surgery literature describes a limited number of techniques that address these concerns, virtually all of which are variants of superior or superior medial pedicle vertical pattern mastopexy. This paper details a safe technique for simultaneous explantation and mastopexy with a novel open marking pattern and vertical bipedicle, which can restore breast cosmesis following implant removal. The study will briefly retrospectively review the results of a consecutive series of 86 patients who underwent this procedure from November 2018 to November 2019, with no incidence of partial or total nipple-areola complex necrosis. Thus, the technique is safe and allows the flexibility for intraoperative adjustments that are necessary for these procedures. A future study will conduct a more in-depth analysis of the results. Level of Evidence: 4

scholarly journals Variables Associated with Short-Term Weight Loss in a Cohort of Patients with Morbid Obesity According to Age and Three Types of Bariatric Surgery

2020 ◽  
Vol 9 (11) ◽  
pp. 3537
Author(s):  
Maria D. Alvarez-Bermudez ◽  
Flores Martin-Reyes ◽  
Luis Ocaña-Wilhelmi ◽  
Francisco J. Moreno-Ruiz ◽  
Juan Alcaide Torres ◽  
...  
Keyword(s):  
Bariatric Surgery ◽  
Morbid Obesity ◽  
Weight Loss ◽  
Age Groups ◽  
The Other ◽  
Atherogenic Index ◽  
Short Term ◽  
Atherogenic Index Of Plasma ◽  
Biochemical Variables ◽  
One Year

Background The percentage of excess weight lost (%EWL) after bariatric surgery (BS) shows great discrepancies from one individual to another. Objective To evaluate the %EWL one year after BS and to determine the existence of baseline biomarkers associated with weight loss. Methods We studied 329 patients with morbid obesity undergoing three types of BS (biliopancreatic diversion (BPD), Roux-en-Y gastric bypass (RYGB) and sleeve gastrectomy (SG)), depending on the %EWL one year after surgery: good responders (GR) (%EWL ≥ 50%) and non-responders (NR) (%EWL < 50%). Results The GR presented a higher percentage of change in anthropometric and biochemical variables compared to the NR group, even within each type of BS. There was a greater percentage of GR among those who underwent RYGB. The patients who underwent SG showed the lowest decrease in biochemical variables, both in GR and NR. Within the GR group, those with a lower age showed greater improvement compared to the other age groups. A %EWL ≥50% was negatively associated with the age and atherogenic index of plasma (AIP), and positively with the type of BS (RYGB). Conclusions The GR group was associated with lower age and AIP and undergoing RYGB. Additionally, those patients who underwent SG showed a lower metabolic improvement.

scholarly journals Association of Circulating Irisin Concentrations with Weight Loss after Roux-en-Y Gastric Bypass Surgery

2019 ◽  
Vol 16 (4) ◽  
pp. 660 ◽  
Author(s):  
Yeon Lee ◽  
Yoonseok Heo ◽  
Ji-Ho Choi ◽  
Sunghyouk Park ◽  
Kyoung Kim ◽  
...  
Keyword(s):  
Bariatric Surgery ◽  
Weight Loss ◽  
Gastric Bypass ◽  
Bypass Surgery ◽  
Excess Weight Loss ◽  
Gastric Bypass Surgery ◽  
Morbidly Obese ◽  
Obese Patients ◽  
Preoperative Serum ◽  
One Year

Irisin is a myokine with potential anti-obesity properties that has been suggested to increase energy expenditure in obese patients. However, there is limited clinical information on the biology of irisin in humans, especially in morbidly obese patients undergoing bariatric surgery. We aimed to assess the association of circulating irisin concentrations with weight loss in obese patients undergoing bariatric surgery. This was a pilot, single-centre, longitudinal observational study. We recruited 25 morbidly obese subjects who underwent Roux-en-Y gastric bypass surgery (RYGBP), and blood samples from 12 patients were taken to measure serum irisin concentrations before, and one and nine months after surgery. Their clinical characteristics were measured for one year. The preoperative serum irisin concentration (mean 1.01 ± 0.23 μg/mL, range 0.73–1.49) changed bidirectionally one month after RYGBP. The mean concentration at nine months was 1.11 ± 0.15 μg/mL (range 0.92–1.35). Eight patients had elevated irisin levels compared with their preoperative values, but four did not. Elevations of irisin levels nine months, but not one month, after surgery, were associated with lower preoperative levels (p = 0.016) and worse weight reduction rates (p = 0.006 for the percentage excess weight loss and p = 0.032 for changes in body mass index). The preoperative serum irisin concentrations were significantly correlated with the percentage of excess weight loss for one year (R2 = 0.612; p = 0.04) in our study. Our results suggest that preoperative circulating irisin concentrations may be at least in part associated with a weight loss effect of bariatric surgery in morbidly obese patients. Further large-scale clinical studies are needed to ratify these findings.

scholarly journals Pulmonary Function after Weight Loss in Obese Women Undergoing Roux-en-Y Gastric Bypass: One-Year Followup

ISRN Obesity ◽  
2013 ◽  
Vol 2013 ◽  
pp. 1-5 ◽  
Author(s):  
Marcela Cangussu Barbalho-Moulim ◽  
Gustavo Peixoto Soares Miguel ◽  
Eli Maria Pazzianotto Forti ◽  
Flávio do Amaral Campos ◽  
Fabiana Sobral Peixoto-Souza ◽  
...  
Keyword(s):  
Bariatric Surgery ◽  
Weight Loss ◽  
Gastric Bypass ◽  
Muscle Strength ◽  
Respiratory Muscle ◽  
Gastric Bypass Surgery ◽  
Respiratory Muscle Strength ◽  
Obese Women ◽  
Lung Volumes ◽  
One Year

Introduction. Obesity is a condition that causes damage to the respiratory function. However, studies have demonstrated that weight loss due to bariatric surgery has resulted in a huge improvement on some lung volumes, but controversy still persists regarding the behavior of the respiratory muscle strength and IRV (inspiratory reserve volume). Objective. To evaluate the effect of weight loss, after 1 year of the Roux-en-Y gastric bypass surgery (RYGB), on the lung volumes and the respiratory muscle strength in obese women. Methods. 24 obese women candidates were recruited for RYGB. Lung volumes (spirometry) and respiratory muscle strength were evaluated in preoperative period and one year after surgery. Results. There was a significant increase in some lung volumes. However, when examining the components of the VC (vital capacity) separately, an increase in ERV (expiratory reserve volume) and reduction of IRV were observed. Moreover, a statistically significant reduction in the values of respiratory muscle strength was recorded: MIP (maximal inspiratory pressure) and MEP (maximal expiratory pressure). Conclusion. Weight loss induced by bariatric surgery provides an increase in some lung volumes of obese women, but reduction in IRV. Additionally, there was also a reduction in the respiratory muscle strength.

scholarly journals An Alternative Treatment of Pseudogynecomastia in Male Patients After Massive Weight Loss

2020 ◽  
Vol 2 (2) ◽  
Author(s):  
Krista L Hardy ◽  
Ran Stark ◽  
Kevin H Small ◽  
Jeffrey M Kenkel
Keyword(s):  
Weight Loss ◽  
Body Contouring ◽  
Retrospective Chart Review ◽  
Massive Weight Loss ◽  
Average Weight ◽  
Level Of Evidence ◽  
Areola Complex ◽  
Attractive Option ◽  
Chest Deformity ◽  
Male Patients

Abstract Background There has been an increase in body contouring procedures following massive weight loss (MWL), including male breast reduction procedures. Treating male chest deformity after MWL using standard mastopexy techniques often leads to suboptimal results. Objectives The authors describe a technique to treat pseudogynecomastia using a modified elliptical excision and nipple-areola complex (NAC) transposition on a thinned inferior dermal pedicle as an alternative to conventional techniques. Methods A retrospective chart review from January 2011 to January 2019 identified a total of 14 male patients who underwent excision of pseudogynecomastia using the described technique. Results Patients were characterized by age, method of weight loss, pre-weight loss body mass index (BMI), post-weight loss BMI, total weight loss, grade of pseudogynecomastia, and concurrent procedures performed. Patients were followed for a period ranging from 3 months to 1.5 years (average, 8.1 months). Pre-weight loss BMI and post-weight loss BMI averaged 52.0 kg/m2 and 29.6 kg/m2, respectively. The average weight lost was 79.72 kg and the average total amount of tissue removed was 2615 g. All patients had concurrent procedures with an average operative time of 274 minutes. Four out of 14 patients (28.6%) experienced minor complications, which included asymmetry, delayed wound healing, seroma, and hyperpigmentation. There were no wound infections, hematomas, flap necrosis, or dysesthesia. Conclusions Due to several cosmetic advantages and low complication profile, our technique using a modified elliptical excision and NAC transfer on an inferior dermal pedicle is an attractive option for treating male chest deformity after MWL. Level of Evidence: 4

scholarly journals Clinical Outcomes of Bariatric Surgery Among Military Retirees and Beneficiaries: A Retrospective Cohort Study

2020 ◽  
Vol 4 (Supplement_2) ◽  
pp. 1677-1677
Author(s):  
Joshua Roe ◽  
Brenda Bustillos ◽  
Adam Kieffer
Keyword(s):  
Bariatric Surgery ◽  
Weight Loss ◽  
Cohort Study ◽  
Clinical Outcomes ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Military Retirees ◽  
Student’S T ◽  
One Year

Abstract Objectives Obesity prevalence is estimated at 34% in U.S. military retirees and 28% in beneficiaries of military healthcare, with common comorbidities being type 2 diabetes (T2D), hypertension, and hyperlipidemia. Stressors experienced during active duty service result in higher risk for disabling musculoskeletal injuries, psychological trauma, and alcohol abuse; all of which debilitate healthy weight loss efforts. No literature exists on the demographics and clinical outcomes of military retirees who elect bariatric surgery. The purpose of this study was to assess demographics and determine clinical outcomes of retirees and beneficiaries following bariatric surgery. It was hypothesized that pre-operative weights and comorbidity remission would be higher in the military retiree group. Methods A retrospective cohort study assessed military retirees and beneficiaries who underwent sleeve gastrectomy or gastric bypass surgery at a military treatment facility in 2014. Percent total weight loss (%TWL) and remission of pre-existing comorbidities (T2D, hypertension, and hyperlipidemia) at one year follow-up were primary outcomes and compared using Student's T tests and chi-squared contingency analysis. Additional statistical analyses included a Wilcoxon-Mann-Whitney test and backwards stepwise regression. Results Ninety-eight patients (64 beneficiaries and 34 retirees) were included with mean ages of 48 and 52 years, respectively. Student's T test and Wilcoxon-Mann-Whitney test confirmed that beneficiaries achieved greater %TWL at one year follow-up, 30.2% vs. 25.8% (p &lt; 0.05) and 55.5 vs. 38.2 mean rank (p &lt; 0.01), respectively. Beneficiaries and retirees achieved similar remission of T2D, hypertension, and hyperlipidemia. Patient's sex and surgery type were significant predictors of %TWL variation between groups at one year follow-up. These variables accounted for 9% of the %TWL variance. Conclusions Retirees who elect bariatric surgery lose less weight than their beneficiary counterparts. Etiology of this poorer outcome remains unclear, but further research may demonstrate need for improving healthcare resources provided to military retirees. Funding Sources No funding was received to support this study.

scholarly journals The Effects of Bariatric Surgery Weight Loss on Knee Pain in Patients with Osteoarthritis of the Knee

Arthritis ◽  
2012 ◽  
Vol 2012 ◽  
pp. 1-7 ◽  
Author(s):  
Christopher Edwards ◽  
Ann Rogers ◽  
Scott Lynch ◽  
Tamara Pylawka ◽  
Matthew Silvis ◽  
...  
Keyword(s):  
Bariatric Surgery ◽  
Weight Loss ◽  
Symptom Relief ◽  
Osteoarthritis Of The Knee ◽  
Rank Tests ◽  
Knee Arthritis ◽  
Knee Oa ◽  
Signed Rank ◽  
Symptomatic Knee ◽  
One Year

Studies have shown that osteoarthritis (OA) is highly associated with obesity, and individuals clinically defined as obese (BMI > 30.0 kg/m2) are four times more likely to have knee OA over the general population. The purpose of this research was to examine if isolated weight loss improved knee symptoms in patients with osteoarthritis. Adult patients (n=24; age 18–70; BMI > 35 kg/m2) with clinical and radiographic evidence of knee OA participated in a one-year trial in which WOMAC and KOOS surveys were administered at a presurgery baseline and six and twelve months postsurgery. Statistical analysis was performed using Student's t and Wilcoxon Signed Rank tests. Weight loss six and twelve months following bariatric surgery was statistically significant (P<0.05) compared to presurgery measurements. All variables from both KOOS and WOMAC assessments were significantly improved (P<0.05) when compared to baseline. Isolated weight loss occurring via bariatric surgery resulted in statistically significant improvement in patient’s knee arthritis symptoms at both six and twelve months. Further research will need to be done to determine if symptom relief continues over time, and if the benefits are also applicable to individuals with symptomatic knee arthritis that are overweight but not obese.

scholarly journals Plastic Surgery After Bariatric Surgery and Massive Weight Loss

2005 ◽  
Vol 80 (1) ◽  
pp. 136 ◽  
Author(s):  
James Knoetgen ◽  
Paul M. Petty ◽  
Craig H. Johnson
Keyword(s):  
Bariatric Surgery ◽  
Weight Loss ◽  
Plastic Surgery ◽  
Massive Weight Loss
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