Abdominal contouring in super obese patients: A single-surgeon review of 22 cases

Background: It is generally believed that increasing obesity is a predictor of postoperative complications after abdominal contouring procedures such as abdominoplasty and panniculectomy. The purpose of this study is to review the complication rate for abdominal contouring in the level 3 obesity category (body mass index [BMI], >40 kg/m) and to examine the safety of this procedure when performed in this select patient population. Methods: Between 2003 and 2008, an institutional review board-approved, single-surgeon, single-institution retrospective review was conducted for all patients presenting for abdominal contouring. In all, 100 patients with precontouring BMI <40 kg/m were excluded, resulting in 22 patients who met the criteria for Level 3 obesity category, which are also referred as "super obese." To date, this is the largest series that has reported pertaining to this category and procedures. Results: In this series, 77% (17/22) had prior bariatric surgery. The mean hospitalization was 2.8 days and mean length of follow-up was 202 days. The major complication rate was 4.5% (1/22). Conclusions: Abdominal contouring can be performed safely, effectively, and with minimal morbidity in the super obese. Only one patient required readmission after developing an infected seroma and all patients progressed to a well-healed wound. BMI >40 kg/m should not preclude patients from undergoing this functional and beneficial surgical procedure.