The purpose of this study was to critically evaluate complications associated with belt lipectomy surgery. The charts of 50 consecutive patients who underwent belt lipectomy surgery at the University of Iowa over a 5-year period were retrospectively evaluated for complications. Forty-five were female and 5 were male, with an average age of 39 years and a range 23-52 years. A total of 42 complications occurred in 50 patients with 22 patients experiencing no complications and 10 patients experiencing multiple complications. Ten complications occurred in 5 males and 32 occurred in 45 females. Sixteen seromas or 32%, 6 dehiscences or 12%, 5 psychiatric difficulties or 10%, 4 infections or 8%, 3 pulmonary emboli or 6%, and 2 unscheduled hospitalizations or 4%, occurred during the series. A number of other complications each occurred once, for a rate of 2% each, which included a deep venous thrombosis, a superficial thigh vein thrombosis, a lower abdominal wall necrosis, a restrictive pulmonary problem, transient stress incontinence, and a pneumo-mediastinum. When the patients were stratified by weight according to Body Mass Index (weight in Kg/[height in meters]2) into normal £ 25, overweight = 25.1-29.9, and obese ³ 30, the rate of complications was 1 in 10 patients or 10%, 17 in 20 patients or 85%, and 24 in 20 patients or 120%, respectively. The rates of complication in this series were compared to previous studies conducted on abdominoplasty patients and the results were comparable, with a few of the complications being unique to the belt lipectomy procedure. It is concluded that belt lipectomy is a procedure that has significant associated risks that must be taken into account when considering surgery. Although none of the complications in this series caused any long-term problems for this group of patients, and the end results justified the means for both the patients and the physicians, it is important to note the trends discovered in this series. Those include; male patients have a higher complication rate, seroma is a very common postoperative problem, dehiscences and psychiatric difficulties are not uncommon, and the higher the patient's Body Mass Index, the greater the likelihood of complications. Overall, it is recommended that patients should be informed of the relatively high rate of complications and minor problems that can occur with belt lipectomy surgery.
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