Zusammenfassung
Mit der Einführung der bariatrischen Chirurgie sind körperformende Eingriffe als neuer
Schwerpunkt in der Plastischen Chirurgie entstanden. Nach einer massiven Gewichtsreduktion
leiden die Patienten unter überschüssig hängender Haut, meist am Gesicht, Stamm, Gesäß,
an den Oberschenkeln, Oberarmen sowie Brüsten. Dies kann bei diesen Patienten zu einer
Verminderung der Lebensqualität sowie der sozialen Anerkennung führen. Patienten mit
solchen Befunden stellen sich bei einem Plastischen Chirurgen vor, um eine Lösung
für dieses Problem zu finden. Demzufolge ist Plastische Chirurgie ein integraler Bestandteil
bei der chirurgischen Therapie morbid adipöser Patienten geworden. Das Hauptziel der
postbariatrischen, plastisch-chirurgischen Behandlung beinhaltet die Wiederherstellung
eines normalen Körpererscheinungsbildes mit möglichst wenigen Eingriffen und dem
geringsten Risiko für die Patienten. Die wichtigsten plastisch-chirurgischen Verfahren
zur Korrektur von Deformitäten der Körpersilhouette werden in diesem Artikel dargestellt.
Zusätzlich werden Hinweise zur Indikationsstellung, hilfreiche technische Details,
wichtige prä- und postoperative Hinweise, die möglichen Komplikationen sowie die zu
erwartenden Ergebnisse beschrieben.
Abstract
With the advent of bariatric surgery, body contouring has grown to a new speciality
in plastic surgery. Following massive weight loss, patients generally have skin redundancy
on the trunk, buttocks, breast, upper arms, thighs and face, leading to a poor quality
of life and social acceptance. This condition motivates many patients to consult a
plastic surgeon to address these problems. Thus, plastic surgery has become an integral
part of the surgical treatment of the morbidly obese. The aim of post-bariatric plastic
surgery should be to restore a normal body image of the patient with as few surgeries
as possible and with a tolerable risk. This article addresses different plastic surgery
procedures that can be successfully applied in order to correct various body contouring
deformities. Patient selection, technical details, pre- and postoperative care, possible
complications and expected results are all discussed.
Schlüsselwörter
körperformende Eingriffe - bariatrische Chirurgie - Plastische Chirurgie - Adipositas
- überschüssig hängende Haut
Key words
body contouring - bariatric surgery - plastic surgery - obesity - skin redundancy
Literatur
- 1
Strauch B, Herman C, Rohde C et al.
Mid-body contouring in the post-bariatric surgery patient.
Plast Reconstr Surg.
2006;
117
2200-2211
- 2
Pitanguy I.
Abdominal lipectomy.
Clin Plast Surg.
1975;
2
401-410
- 3
Illouz Y G.
Body contouring by lipolysis: a 5-year experience with over 3 000 cases.
Plast Reconstr Surg.
1983;
72
591-597
- 4
Regnault P.
Abdominoplasty by the W technique.
Plast Reconstr Surg.
1975;
55
265-274
- 5
Lockwood T.
High-lateral-tension abdominoplasty with superficial fascial system suspension.
Plast Reconstr Surg.
1995;
96
603-615
- 6
Momeni A, Heier M, Bannasch H et al.
The “rising-sun-technique” in abdominoplasty.
Ann Plast Surg.
2008;
60
343-348
- 7
Momeni A, Torio-Padron N, Bannasch H et al.
A new method for reducing postoperative complications and scar length in abdominoplasty.
Plast Reconstr Surg.
2008;
121
227e-228e
- 8
Wallach S G.
Treating the abdominotorso region of the massive weight loss patient: an algorithmic
approach.
Plast Reconstr Surg.
2008;
121
1431-1441
- 9
Toranto I R.
The relief of low back pain with the WARP abdominoplasty: a preliminary report.
Plast Reconstr Surg.
1990;
85
545-555
- 10
Aly A S, Cram A E, Chao M et al.
Belt lipectomy for circumferential truncal excess: the University of Iowa experience.
Plast Reconstr Surg.
2003;
111
398-413
- 11
Lockwood T E.
Fascial anchoring technique in medial thigh lifts.
Plast Reconstr Surg.
1988;
82
299-304
- 12
Pitanguy I.
Evaluation of body contouring surgery today: a 30-year perspective.
Plast Reconstr Surg.
2000;
105
1499-1514
, discussion 1515–1516
- 13
Lockwood T.
Lower body lift with superficial fascial system suspension.
Plast Reconstr Surg.
1993;
92
1112-1122
, discussion 1123–1125
- 14
Reichenberger M A, Stoff A, Richter D F.
Body contouring surgery in the massive weight loss patient.
Chirurg.
2007;
78
326-334
- 15
Lockwood T.
Brachioplasty with superficial fascial system suspension.
Plast Reconstr Surg.
1995;
96
912-920
- 16
Hurwitz D J, Holland S W.
The L brachioplasty: an innovative approach to correct excess tissue of the upper
arm, axilla, and lateral chest.
Plast Reconstr Surg.
2006;
117
403-411
, discussion 412–413
- 17
Chandawarkar R Y, Lewis J M.
‘Fish-incision’ brachioplasty.
J Plast Reconstr Aesthet Surg.
2006;
59
521-525
- 18
Hinderer U T, del Rio J L.
Erich Lexer's mammaplasty.
Aesthetic Plast Surg.
1992;
16
101-107
- 19
Lexer E.
Corrección de los pechos péndulos (Mastoptose).
San Sebastian Guipúzcoa Médica.
1921;
63
213
- 20
Hoehler H.
Die Reduktionsmammaplastik bei Hyperplasien der Weiblichen Brust.
Chirurg.
1977;
48
377
- 21
Pitanguy I.
Surgical treatment of breast hypertrophy.
Br J Plast Surg.
1967;
20
78-85
- 22
Lejour M.
Vertical mammaplasty.
Plast Reconstr Surg.
1993;
92
985-986
- 23
Lejour M.
Vertical mammaplasty and liposuction of the breast.
Plast Reconstr Surg.
1994;
94
100-114
- 24
Stark G B, Grandel S, Spilker G.
Tissue suction of the male and female breast.
Aesthetic Plast Surg.
1992;
16
317-324
- 25
Voigt M, Walgenbach K J, Andree C et al.
Minimally invasive surgical therapy of gynecomastia: liposuction and exeresis technique.
Chirurg.
2001;
72
1190-1195
- 26
Finckenstein J G, Wolf H.
Chest lifting.
Aesthetic Plast Surg.
2006;
30
286-293
- 27
Shermak M A, Chang D, Magnuson T H et al.
An outcomes analysis of patients undergoing body contouring surgery after massive
weight loss.
Plast Reconstr Surg.
2006;
118
1026-1031
- 28
Shermak M A, Rotellini-Coltvet L A, Chang D.
Seroma development following body contouring surgery for massive weight loss: patient
risk factors and treatment strategies.
Plast Reconstr Surg.
2008;
122
280-288
- 29
Shermak M A, Chang D C, Heller J.
Factors impacting thromboembolism after bariatric body contouring surgery.
Plast Reconstr Surg.
2007;
119
1590-1596
, discussion 1597–1598
- 30
Sarwer D B, Thompson J K, Cash T F.
Body image and obesity in adulthood.
Psychiatr Clin North Am.
2005;
28
69-87viii
Dr. N. Torio-Padron
Abteilung für Plastische und Handchirurgie · Universitätsklinikum Freiburg
Hugstetter Str. 55
79106 Freiburg
Phone: 07 61 / 2 70 28 17
Fax: 07 61 / 2 70 25 01
Email: nestor.torio.padron@uniklinik-freiburg.de
