과다 체중 감량 환자에서의 허리띠 피부지방절제술의 치험례

Body Contouring of Breast and Abdomen with Belt Dermolipectomy after Massive Weight Loss: A Case Report

  • 김종석 (가톨릭대학교 의과대학 성형외과학교실) ;
  • 서제원 (가톨릭대학교 의과대학 성형외과학교실) ;
  • 오득영 (가톨릭대학교 의과대학 성형외과학교실) ;
  • 이중호 (가톨릭대학교 의과대학 성형외과학교실) ;
  • 안상태 (가톨릭대학교 의과대학 성형외과학교실) ;
  • 이종원 (가톨릭대학교 의과대학 성형외과학교실)
  • Kim, Jong-Sok (Department of Plastic Surgery, College of Medicine, The Catholic University of Korea) ;
  • Seo, Je-Won (Department of Plastic Surgery, College of Medicine, The Catholic University of Korea) ;
  • Oh, Deuk-Young (Department of Plastic Surgery, College of Medicine, The Catholic University of Korea) ;
  • Lee, Jung-Ho (Department of Plastic Surgery, College of Medicine, The Catholic University of Korea) ;
  • Ahn, Sang-Tae (Department of Plastic Surgery, College of Medicine, The Catholic University of Korea) ;
  • Rhie, Jong-Won (Department of Plastic Surgery, College of Medicine, The Catholic University of Korea)
  • 투고 : 2010.04.20
  • 심사 : 2010.08.10
  • 발행 : 2010.09.10

초록

Purpose: Obese proportion is increasing universally, estimating more than a billion. So reducing the weight became one of the topic in medical market. Not only diet, exercise, medication, but also many surgical procedures are being developed, such as sleeve gastrectomy, gastric bypass surgery. After massive weight loss, skin excess and laxity occurs, leading to unsatisfying body contour. Body contouring surgery including abdominoplasty, breast reduction is performed when skin excess is present in abdomen and breast. When skin excess is present circumferentially, belt dermolipectomy is the treatment of choice. Methods: A 23-year-old man had weight gain since he was 12 of age. A year before visiting to our department, his height was 168 cm, weight was 150 kg and body mass index (BMI) was 53.15 kg/$m^2$. The patient lost 55 kg of his weight through exercise and diet control. When he visited again, his weight was 95 kg and BMI was 33.66 kg/$m^2$. In physical examination, skin excess and laxity was seen in both breast and abdomen circumferentially and lateral folds were seen in the back. Abdominal contour deformity (Pitman classification type 6) and pseudogynecomastia (grade 3) were present in both breast. Belt dermolipectomy of abdomen, both breast and lateral folds was performed, resecting 6,400 g of tissue and additive 1,200 g through revisional operation. Results: The patient lost 6,500g of his weight and BMI reduced by 2.3 kg/$m^2$. The patient's hospital course was uneventful during 5 weeks of hospitalization and he was satisfied with his final body contour. Conclusion: Body contouring with belt dermolipectomy in patient who has circumferential skin excess and laxity after massive weight loss can be a treatment of choice.

키워드

참고문헌

  1. Shermak MA, Bluebond-Lngner R, Chang D: Maintenance of weight loss after body contouring surgery for massive weight loss. Plast Reconstr Surg 121: 2114, 2008 https://doi.org/10.1097/PRS.0b013e3181708129
  2. Gusenoff JA, Coon D, Rubin JP: Pseudogynecomastia after massive weight loss: detectability of technique, patient satisfaction, and classification. Plast Reconstr Surg 122: 1301, 2008 https://doi.org/10.1097/PRS.0b013e3181881df4
  3. Murshid M, Khalid KN, Shakir A, Bener A: Abdominoplasty in obese and in morbidly obese patients. J Plast Reconstr Aesthet Surg 63: 820, 2010 https://doi.org/10.1016/j.bjps.2009.01.074
  4. Wallach SG: Abdominal contour surgery for the massive weight loss patient: the fleur-de-lis approach. Aesthet Surg J 25: 454, 2005 https://doi.org/10.1016/j.asj.2005.06.001
  5. SE Kim, JJ Kim, JH Jeong, JH Seul: Abdominal dermoli-pectomy. J Korean Soc Plast Reconstr Surg 22: 152, 1995
  6. Fuente del Campo A, Rojas Allegretti E, Fernandez Filho JA, Gordon CB: Regional dermolipectomy as treatment for sequelae of massive weight loss. World J Surg 22: 974, 1998 https://doi.org/10.1007/s002689900502
  7. Taylor GI, Corlett RJ, Boyd JB: The versatile deep inferior epigastric (inferior rectus abdominis) flap. Br J Plast Surg 37: 330, 1984 https://doi.org/10.1016/0007-1226(84)90076-6
  8. Schlenz I, Rigel S, Schemper M, Kuzbari R: Alteration of nipple-areolar sensitivity by reduction mammaplasty: a prospective comparison of five techniques. Plast Reconstr Surg 115: 743, 2005 https://doi.org/10.1097/01.PRS.0000152435.03538.43
  9. Nahai FR, Nahai F: MOC-PSSM CME Article: Breast reduction. Plast Reconstr Surg 121: 1, 2008