Dr. Jeffrey Kenkel Examines Surgical Wound Healing in Massive Weight Loss Patients

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Dr. Jeffrey M. Kenkel, a Dallas plastic surgeon and body contouring specialist, recently studied wound healing and the incidence of complications in massive weight loss patients who undergo aesthetic surgery.

Jeffrey M. Kenkel, M.D.

Jeffrey M. Kenkel, M.D.

In addition to identifying massive weight loss patients as a vulnerable population, these types of studies are important to help surgeons improve patient care.

Dr. Jeffrey M. Kenkel, Dallas plastic surgeon, Professor and Vice-Chairman of the Department of Plastic Surgery at UT Southwestern Medical Center, recently published a correlative study in the "Aesthetic Surgery Journal," a publication issued by the American Society for Aesthetic Plastic Surgery. The paper, "The Effect of Massive Weight Loss Status, Amount of Weight Loss, and Method of Weight Loss on Body Contouring Outcomes" investigated the likelihood of complications in patients who undergo body contouring after massive weight loss (MWL) over 50 pounds.

"This is one of the first large-scale studies comparing outcomes in patients losing significant amount of weight via surgical and non-surgical means," explained Dr. Kenkel, who sees many of these patients in his Dallas plastic surgery clinic. "The study reviewed data from 450 body contouring patients, including 124 who had undergone massive weight loss by various methods before the procedure."

Dr. Kenkel and his peers conducted a statistical analysis to identify risk factors and determine the probability of patients experiencing healing issues or complications after their surgery.

Patients included men and women in all age groups who had undergone various body contouring procedures, including body lifts, tummy tucks, thighplasty, arm lifts, breast lifts or breast reduction, and liposuction. Given the increasing frequency of body contouring on both MWL and non-MWL patients, this is a timely investigation of factors that influence complication rates. Several key findings were noted.

Patients with weight loss over 100 pounds had a significant statistical risk, regardless of weight loss method. Furthermore, post-bariatric patients had the highest rate of complications. Gastric bypass patients had a greater risk than patients who lost weight through diet and exercise. Patients who underwent restrictive bariatric procedures, such as gastric sleeve or the Lap-Band, had the lowest risk among surgical weight loss patients.

With these considerations in mind, Dr. Kenkel investigated physiological factors that make MWL patients susceptible to complications, such as infection, delayed healing, ruptures, and reddening of the skin. Dr. Kenkel explained, "In addition to identifying massive weight loss patients as a vulnerable population, these types of studies are important to help surgeons improve patient care. The data that we have collected is valuable in managing known risks and orchestrating pre- and post-surgical treatment."

One reason why post-bariatric patients have more complications is nutrition. Following bariatric procedures, many patients consume less than 1,000 calories daily, which leads to lower protein levels and nutritional deficiencies. Their bodies adapt to their new nutritional state which then changes when the body becomes stressed by surgery. It is imperative that patients account for their deficiencies and prepare their bodies for surgery. Nutrition plays an important role in skin healing, collagen production, and the generation of new blood vessels, all of which are important during recovery.

To improve patient health, Dallas plastic surgeons at UTSW currently conduct nutritional assessments and administer protein and vitamin supplements. "Surgeons should monitor these patients carefully and make sure their vitamin and protein supplements are complete. Daily protein supplements are vital for achieving complication rates that are in line with non-bariatric candidates," says Dr. Kenkel. "We can also enhance recovery by tailoring pre-operative care to the patient's weight loss amount and method. As our understanding of these risks advance, it allows us to give the growing number of body contouring patients the best possible circumstances for a safe recovery."


About Dr. Jeffrey M. Kenkel

Jeffrey M. Kenkel, M.D., F.A.C.S., is a plastic surgeon located in Dallas, Texas. In addition to Program Director, he serves as Professor and Vice-Chairman of the Department of Plastic Surgery at UT Southwestern Medical Center. He is also Director of the Clinical Center for Cosmetic Laser Treatment and Medical Director for the Department of Plastic Surgery. His clinical practice is located at the Outpatient Building on the UT Southwestern campus.

Dr. Kenkel has served as president of The American Society for Aesthetic Plastic Surgery and is certified by the American Board of Plastic Surgery. Dr. Kenkel specializes in cosmetic surgery of the face, breast and body. He balances his surgical practice with nonsurgical cosmetic medicine including the use of injectables, cosmetic lasers, and skin care. Dr. Kenkel is nationally and internationally known for his contributions in cosmetic surgery.

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Jeffrey M. Kenkel M.D.