Incidence and Risk Factors of Major Complications in Brachioplasty: Analysis of 2,294 patients
Lyly Nguyen, MD1, Varun Gupta, MD1, Ashkan Afshari, MD1, R. Bruce Shack, MD1, James C. Grotting, MD2, K. Kye Higdon, MD1.
1Vanderbilt University, Nashville, TN, USA, 2University of Alabama, Birmingham, AL, USA.
PURPOSE: Brachioplasty is a popular procedure to correct upper arm ptosis. However, current literature on complications and risk factors is scant and inconclusive. Using a large, prospective, multicenter
database, we report the incidence of major complications and risk factors in patients undergoing brachioplasty.
METHODS: Patients who underwent brachioplasty between 2008- 2013 were identified from the CosmetAssure database. The primary outcome was the occurrence of major complication(s), defined as complications requiring emergency room visit, hospital admission, or reoperation within thirty days of the procedure. Risk factors including age, gender, body mass index (BMI), smoking, diabetes, combined procedures, and type of surgical facility were evaluated using univariate and multivariate analysis.
RESULTS: Within the 129,007 patients enrolled in CosmetAssure, 2,294 (1.8%) underwent brachioplasty. Brachioplasty patients were more likely to be older than 50 years (50.1%), obese (36.3%), diabetic (5.5%),
but less likely smokers (5.5%). Major complications occurred in 3.4% brachioplasties with infection (1.7%) and hematoma (1.1%) being most common. Combined procedures, performed in 66.8% cases, had a complication rate of 4.4%, in comparison to 1.3% for brachioplasties performed alone. Combined procedures (RR= 3.58), males (RR= 3.44), and BMI ≥ 30kg/m2 (RR=1.92) were identified as independent risk factors for the occurrence of any complication. Combined procedures (RR=12.42), and the male gender (RR= 8.89) increased the risk of hematoma formation.
CONCLUSION: Complication rates from brachioplasty are much
lower than previously reported. Hematoma and infection are the most common major complications. Combined procedures, male gender, and BMI ≥ 30kg/m2 are independent risk factors for complications.
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