Men at Higher Risk of Wound Complications after Body Contouring Surgery
Increasing Number of Males Undergoing Lower Body Lifts and Abdominoplasty

ARLINGTON HEIGHTS, Ill. - Certain types of wound complications are more frequent in men undergoing body contouring after weight-loss (bariatric) surgery, compared to women, suggests a study in the August issue of Plastic and Reconstructive Surgery®, the official medical journal of the American Society of Plastic Surgeons (ASPS).

As more men undergo bariatric surgery and body contouring, plastic surgeons need to be aware of and inform their patients about the possible increase in complications, suggests the new study by Dr. Tae Chong of University of Texas Southwestern Medical Center, Dallas, and colleagues.

Increased Risk of Hematoma and Seroma after Body Contouring in Men

The researchers compared complications between men and women in a large database of patients undergoing body contouring. Body contouring refers to several different types of plastic surgery procedures done to remove excess fat and skin in patients with massive weight loss-usually after bariatric surgery.

Of 481 patients in the database, only 10 percent were male. The most common body contouring procedures in men were surgery to remove excess tissue in the chest, back and arms (upper body lift) and in the genital area. Women were more likely to undergo surgery on the thighs and buttocks (lower body lift) and upper arms.

The overall complication rate was 42 percent. Two specific types of wound-related complications were more common in men undergoing body contouring. Hematomas (collections of blood under the skin) occurred in 14.6 percent of men versus 3.5 percent of women. Seromas (collections of wound fluid) were also more common in men: 25 versus 13 percent.

With adjustment for other factors, the risk of hematomas was nearly four times higher in men, while seroma risk was nearly three times higher. As a result of these risks, men had a higher overall complication rate. Other complications-including infections and other more serious wound-healing complications-were not significantly different between the sexes.

Increasing numbers of patients who have undergone bariatric surgery for obesity seek body contouring to remove excess skin and fat and improve the shape and tone of underlying tissues. Because women account for a large majority of these patients, there is little data on the outcomes and risks of body contouring in men. Some studies have suggested that men are at higher risk of wound complications after plastic surgery.

The new study finds higher rates of seromas and hematomas in men after body contouring, compared to women. The reasons for this sex-related difference in complications are unclear. Some potential contributing factors-such as greater amounts of tissue removed and higher blood pressure in men-can't explain the differences observed.

"Men who are considering body contouring surgery should be advised that they are at an increased risk of postoperative hematoma and seroma formation," Dr. Chong and coauthors write. For now, men represent only a small minority of body contouring patients, but there has been a significant increase in males undergoing lower body lifts and abdominoplasty since 2000. Further experience and research may help to identify factors contributing to the higher risk of wound complications in men, thus helping to increase the safety of body contouring surgery.

Plastic and Reconstructive Surgery® is published by Lippincott Williams & Wilkins, part of Wolters Kluwer Health.