Z Brachiothoracoplasty for Body Contouring after Massive Weight Loss

DOI: 10.5935/2177-1235.2015RBCP0155 Institution: Hospital Estadual de Sapopemba HESAP, São Paulo, SP, Brazil. Introduction: Brachioplasty treats deformities of the upper limbs. Lateral thoracoplasty treats the upper torso. Brachioplasties, thoracoplasties, and brachiothoracoplasties have been performed with Z-plasty for deformities of the upper limbs and upper third of the chest, in the Sapopemba State Hospital. Objective: We describe modifications of surgical technique for the performance of Z brachiothoracoplasty, and evaluate the results of treatment of deformities of the lateral chest. Method: Thirty-one Patients underwent brachiothoracoplasty and lateral thoracoplasty. The demarcation was made with the patient upright, and the upper limbs abducted at 90o. Marking for brachioplasty was performed using a double-ellipse, to lengthen the modified demarcation along the anterior axillary line toward the inframammary crease in a Z shape. Results: All patients reported an improvement in the contour of the region, and there were no complaints regarding the positioning of the scar. Discussion: Z brachiothoracoplasty consists of extending the incision line on the medial aspect of the arm, passing proximally to the axilla, and continuing through the midaxillary line to the inframammary crease. There was an improvement in the contour of the dorsal region and the skin folds of the lateral thoracic region. Conclusion: Z brachiothoracoplasty and lateral thoracoplasty have the great advantage of eliminating a circumferential scar on the upper torso, thereby improving the contour of the region through skin resection in both the craniocaudal and anteroposterior directions. ■ ABSTRACT