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Published in: Obesity Surgery 9/2008

01-09-2008 | Research Article

Thighplasty After Bariatric Surgery: Evaluation of Lymphatic Drainage in Lower Extremities

Authors: Cristina Hachul Moreno, Henrique Jorge Guedes Neto, Américo Helene Junior, Carlos Alberto Malheiros

Published in: Obesity Surgery | Issue 9/2008

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Abstract

Background

Bariatric surgery for morbid obesity achieves an accentuated weight loss, with skin and soft tissue redundancy in some corporal segments, including the thighs. The thigh lift is a plastic surgery that improves this redundant tissue in the medial thigh area, but this surgical procedure may have complications, such as inferior migration of the scar, delayed wound healing, vulvar distortion, and lymphatic system alterations.

Methods

To evaluate the effect of the thighplasty on the lymphatic system, 14 patients were prospectively included in this study. Lymphoscintigraphy was performed before thighplasty, and this result was compared to the new examination performed 6 months after thighplasty. The exclusion standards include patients with clinical alterations and abnormal lymphoscintigraphy in previous surgery.

Results

The statistical analysis was performed on 26 inferior members, according to exclusion standards. All the members had normal lymphoscintigraphy in the preoperative period. After thighplasty, eight members (30.8%) demonstrated abnormal lymphoscintigraphy (p = 0.008) resulting in significant functional and anatomic alterations in the lymphatic system.

Conclusion

The thigh lift changes lymphatic drainage in lower extremities according to lymphoscintigraphy analyses.
Literature
1.
go back to reference Seidell CJ, Flegal MK. Assessing obesity: classification and epidemiology. Br Med Bull 1997;53:238–52.PubMed Seidell CJ, Flegal MK. Assessing obesity: classification and epidemiology. Br Med Bull 1997;53:238–52.PubMed
2.
go back to reference Pitanguy I, Amorim NFG, Radwanski HN. Countour surgery in the patient with great weight loss. Aesthet Plast Surg 2000;24:406–11.CrossRef Pitanguy I, Amorim NFG, Radwanski HN. Countour surgery in the patient with great weight loss. Aesthet Plast Surg 2000;24:406–11.CrossRef
3.
go back to reference Kenkel JM. Body contouring surgery after massive weight loss. Plast Reconstr Surg 2006;117 Suppl 1:1–86S. Kenkel JM. Body contouring surgery after massive weight loss. Plast Reconstr Surg 2006;117 Suppl 1:1–86S.
5.
go back to reference Kolanowski J. Surgical treatment for morbid obesity. Br Med Bull 1997;53:433–44.PubMed Kolanowski J. Surgical treatment for morbid obesity. Br Med Bull 1997;53:433–44.PubMed
6.
go back to reference Nasser D, Elias AA. Indicação de tratamento cirúrgico da obesidade grave. In: Garrido AB Jr, editor. Cirurgia da obesidade. São Paulo: Atheneu; 2002. p. 45–6. Nasser D, Elias AA. Indicação de tratamento cirúrgico da obesidade grave. In: Garrido AB Jr, editor. Cirurgia da obesidade. São Paulo: Atheneu; 2002. p. 45–6.
7.
go back to reference Sanger C, David LR. Impact of significant weight loss on outcome of body-contouring surgery. Ann Plast Surg 2006;56:9–13.PubMedCrossRef Sanger C, David LR. Impact of significant weight loss on outcome of body-contouring surgery. Ann Plast Surg 2006;56:9–13.PubMedCrossRef
8.
go back to reference Ersek RA, Salisbury AV. The saddle lifts for thigh thighs. Aesthet Plast Surg 1995;9:341–3.CrossRef Ersek RA, Salisbury AV. The saddle lifts for thigh thighs. Aesthet Plast Surg 1995;9:341–3.CrossRef
9.
go back to reference Lockwood TE. Fascial anchoring technique in medial thigh lifts. Plast Reconstr Surg 1988;82:299–304.PubMedCrossRef Lockwood TE. Fascial anchoring technique in medial thigh lifts. Plast Reconstr Surg 1988;82:299–304.PubMedCrossRef
10.
go back to reference Lockwood TE. Transverse flank–thigh–buttock lifts with superficial fascial suspension. Plast Reconstr Surg 1991;87:1019–27.PubMedCrossRef Lockwood TE. Transverse flank–thigh–buttock lifts with superficial fascial suspension. Plast Reconstr Surg 1991;87:1019–27.PubMedCrossRef
11.
go back to reference Lockwood TE. Lower body lifts with superficial fascial system suspension. Plast Reconstr Surg 1993;92:1112–22; discussion 1123–5.PubMed Lockwood TE. Lower body lifts with superficial fascial system suspension. Plast Reconstr Surg 1993;92:1112–22; discussion 1123–5.PubMed
12.
go back to reference Candiani P, Campiglio GL, Signorini M. Fascio-fascial suspension technique in medial thigh lifts. Aesthetic Plast Surg 1995;19:137–40.PubMedCrossRef Candiani P, Campiglio GL, Signorini M. Fascio-fascial suspension technique in medial thigh lifts. Aesthetic Plast Surg 1995;19:137–40.PubMedCrossRef
13.
go back to reference Le Louarn C, Pascal JF. The concentric medial thigh lift. Aesthet Plast Surg 2004;28:20–3. Le Louarn C, Pascal JF. The concentric medial thigh lift. Aesthet Plast Surg 2004;28:20–3.
14.
go back to reference Regnault P, Daniel R. Secondary thigh–buttock deformities after classical techniques. Prevention and treatment. Clin Plast Surg 1984;11:505–16.PubMed Regnault P, Daniel R. Secondary thigh–buttock deformities after classical techniques. Prevention and treatment. Clin Plast Surg 1984;11:505–16.PubMed
15.
go back to reference Khan O, Maharaj P, Rampaul R, Archibald A, Naipaul R, Loutan N. Lymphoscintigraphic evaluation of chronic lower limb oedema. West Indian Med J 2003;52:136–9.PubMed Khan O, Maharaj P, Rampaul R, Archibald A, Naipaul R, Loutan N. Lymphoscintigraphic evaluation of chronic lower limb oedema. West Indian Med J 2003;52:136–9.PubMed
16.
go back to reference Cestari SC, Petri V, Castiglioni ML, Lederman H. Linfedemas dos membros inferiores: estudo linfocintilográfico. Rev Assoc Med Bras 1994;40:93–100.PubMed Cestari SC, Petri V, Castiglioni ML, Lederman H. Linfedemas dos membros inferiores: estudo linfocintilográfico. Rev Assoc Med Bras 1994;40:93–100.PubMed
17.
go back to reference Hung JC, Wiseman GA, Wahner HW, Mullan BP, Taggart TR, Dunn WL. Filtered technetium-99m-sulfur colloid evaluated for lymphoscintigraphy. J Nucl Med 1995;36:1895–901.PubMed Hung JC, Wiseman GA, Wahner HW, Mullan BP, Taggart TR, Dunn WL. Filtered technetium-99m-sulfur colloid evaluated for lymphoscintigraphy. J Nucl Med 1995;36:1895–901.PubMed
18.
go back to reference Chandawarkar RY. Body contouring following massive weight loss resulting from bariatric surgery. Adv Psychosom Med 2006;27:61–72.PubMedCrossRef Chandawarkar RY. Body contouring following massive weight loss resulting from bariatric surgery. Adv Psychosom Med 2006;27:61–72.PubMedCrossRef
19.
20.
go back to reference Frick A, Hoffmann JN, Baumeister RG, Putz R. Liposuction technique and lymphatic lesions in lower legs: anatomic study to reduce risks. Plast Reconstr Surg 1999;103:1868–73; discussion 1874–5.PubMedCrossRef Frick A, Hoffmann JN, Baumeister RG, Putz R. Liposuction technique and lymphatic lesions in lower legs: anatomic study to reduce risks. Plast Reconstr Surg 1999;103:1868–73; discussion 1874–5.PubMedCrossRef
21.
go back to reference Gloviczki P, Calcagno D, Schirger A, Pairolero PC, Cherry Kj, Hallett JW, et al. Noninvasive evaluation of the swollen extremity: experiences with 190 lymphoscintigraphic examinations. J Vasc Surg 1989;9:683–9; discussion 690.PubMedCrossRef Gloviczki P, Calcagno D, Schirger A, Pairolero PC, Cherry Kj, Hallett JW, et al. Noninvasive evaluation of the swollen extremity: experiences with 190 lymphoscintigraphic examinations. J Vasc Surg 1989;9:683–9; discussion 690.PubMedCrossRef
22.
go back to reference Szuba A, Shin WS, Strauss HW, Rockson S. The third circulation: radionuclide lymphoscintigraphy in the evaluation of lymphedema. J Nucl Med 2003;44:43–57.PubMed Szuba A, Shin WS, Strauss HW, Rockson S. The third circulation: radionuclide lymphoscintigraphy in the evaluation of lymphedema. J Nucl Med 2003;44:43–57.PubMed
23.
go back to reference Ter SE, Alavi A, Kim CK, Merli G. Lymphoscintigraphy. A reliable test for the diagnosis of lymphedema. Clin Nucl Med 1993;18:646–54.PubMedCrossRef Ter SE, Alavi A, Kim CK, Merli G. Lymphoscintigraphy. A reliable test for the diagnosis of lymphedema. Clin Nucl Med 1993;18:646–54.PubMedCrossRef
24.
go back to reference Yeh SD, Morse MJ, Grando R, Kleinert EL, Whitmore WF. Lymphoscintigraphic studies of lymphatic drainage from the testes. Clin Nucl Med 1986;11:823–7.PubMedCrossRef Yeh SD, Morse MJ, Grando R, Kleinert EL, Whitmore WF. Lymphoscintigraphic studies of lymphatic drainage from the testes. Clin Nucl Med 1986;11:823–7.PubMedCrossRef
25.
go back to reference Williams WH, Witte CL, Witte MH, McNeill GC. Radionuclide lymphangioscintigraphy in the evaluation of peripheral lymphedema. Clin Nucl Med 2000;25:451–64.PubMedCrossRef Williams WH, Witte CL, Witte MH, McNeill GC. Radionuclide lymphangioscintigraphy in the evaluation of peripheral lymphedema. Clin Nucl Med 2000;25:451–64.PubMedCrossRef
26.
go back to reference Leitner DW, Sherwood RC. Inguinal lymphocele as a complication of thighplasty. Plast Reconstr Surg 1983;72:878–81.PubMedCrossRef Leitner DW, Sherwood RC. Inguinal lymphocele as a complication of thighplasty. Plast Reconstr Surg 1983;72:878–81.PubMedCrossRef
27.
go back to reference Van der Stricht J. Surgery of lipodistrophy. Phebologie 1988;41:589–91. Van der Stricht J. Surgery of lipodistrophy. Phebologie 1988;41:589–91.
Metadata
Title
Thighplasty After Bariatric Surgery: Evaluation of Lymphatic Drainage in Lower Extremities
Authors
Cristina Hachul Moreno
Henrique Jorge Guedes Neto
Américo Helene Junior
Carlos Alberto Malheiros
Publication date
01-09-2008
Publisher
Springer-Verlag
Published in
Obesity Surgery / Issue 9/2008
Print ISSN: 0960-8923
Electronic ISSN: 1708-0428
DOI
https://doi.org/10.1007/s11695-007-9400-z

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