The Constriction Arm Band Deformity in Brachioplasty Patients: Characterization and Incidence Using a Prospective Registry.

ABSTRACT

BACKGROUND: Demand for brachioplasty in the United States has seen a dramatic increase, from 338 procedures in 2000 to 17,860 in 2016. In this article, the authors present their series of arm band deformities not yet described in the literature. METHODS: This is a retrospective review of massive weight loss patients undergoing brachioplasty at their institution from 2000 to 2016. Preoperative and postoperative photographs were reviewed. Descriptive statistics and t test were used. RESULTS: One hundred seventy-two patients underwent brachioplasty, and 25 patients (15 percent) were identified with the deformity. Twenty-four (96 percent) were women, with an average age of 60 years (range, 36 to 85 years) and a mean body mass index of 34 kg/m at the time of surgery (average, 2 years since gastric bypass; mean delta body mass index, 22 kg/m). The bands were generally single bands (100 percent) found bilaterally (68 percent) in the distal third (74 percent) of the upper arm and exacerbated (50 percent) by brachioplasty. The average specimen weighed 1005 g. The authors found that arm banding was associated with a higher current body mass index, but not with a maximum body mass index or delta body mass index. CONCLUSIONS: For massive weight loss patients, arm band deformity is a challenging problem that can be exacerbated by brachioplasty. It can be identified preoperatively to aid in counseling. The authors found patients with a higher current body mass index to be at a higher risk for the arm band deformity after brachioplasty. CLINICAL QUESTION/LEVEL OF EVIDENCE Risk, IV.