title: The incidence and management of secondary abdominoplasty and secondary abdominal contour surgery.
abstract: BACKGROUND
  Limited data exist in the literature regarding the general incidence of secondary abdominal contour procedures and secondary abdominoplasty (excluding revisions) or specific recommendations for surgical management of these patients.
  
  
  METHODS
  The authors performed a retrospective chart review of 562 patients who underwent abdominal contouring procedures (liposuction and/or modified or full abdominoplasty) performed by a single surgeon (A.M.) from January of 2004 until October of 2012. Nonsurgical primary cases, secondary surgery that was revisional in nature, and massive weight loss patients were excluded.
  
  
  RESULTS
  Seventy-three patients (13.0 percent) underwent secondary abdominal contouring procedures. Forty-six of 73 patients had charts available to be examined in greater detail. Thirty-four of these patients underwent secondary liposuction, whereas 12 of these patients had secondary full abdominoplasty procedures. Secondary operations occurred an average of 4.98 years after the primary procedure (range, 6 months to 15 years). Patients underwent secondary liposuction (n = 34) on average 3.16 years after their initial procedure, significantly sooner than patients who underwent secondary abdominoplasty (n = 12) 8.35 years after their initial procedure (p = 0.002). Patients with a body mass index less than 25 kg/m2 (n = 26) had both secondary liposuction (n = 16) and secondary abdominoplasty (n = 10), whereas all patients who had a body mass index of 25 kg/m2 or greater (n = 20) underwent only secondary liposuction.
  
  
  CONCLUSIONS
  True secondary abdominal contouring procedures represented 13.0 percent of all abdominal contouring procedures. The most common indication for a secondary procedure was an umbilical-site closure scar. Specific recommendations for surgical management of five common scenarios for secondary abdominal procedures are discussed.
authors.affiliation: New York, N.Y. From private practice and the Department of Plastic Surgery, Institute of Reconstructive Plastic Surgery, New York University Langone Medical Center.
authors.forename: Alan
authors.initials: A
authors.lastname: Matarasso
authors.forename: Lisa F
authors.initials: LF
authors.lastname: Schneider
authors.forename: Jason
authors.initials: J
authors.lastname: Barr
mesh_terms: D061645:Abdominoplasty / Q000706:statistics & numerical data*; D000328:Adult; D000368:Aged; D002921:Cicatrix / Q000453:epidemiology / Q000601:surgery; D016208:Databases, Factual / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D015994:Incidence; D015187:Lipectomy / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D009767:Obesity, Morbid / Q000453:epidemiology* / Q000601:surgery*; D011183:Postoperative Complications / Q000453:epidemiology* / Q000601:surgery; D012086:Reoperation / Q000706:statistics & numerical data*; D012189:Retrospective Studies