title: Morbidity in combined-procedure associating abdominoplasty and breast surgery: A systematic review.
abstract: OBJECTIVE
  Combined aesthetic procedures are an increasing procedure and demands of the patients. The authors have assembled concrete arguments detailing the risks of combined-surgery associating abdominoplasty and mammoplasty relative to abdominoplasty alone. The purpose of this study was to compare abdominoplasty alone versus abdominoplasty combined with breast surgery in terms of short-term complications, in support of surgical choices.
  
  
  METHODS
  Through application of the PRISMA criteria, we have realized a systematic review of the literature from 1969 to April 2015 in English and French languages by searching in MEDLINE®, PubMed central, Embase and Cochrane Library databases.
  
  
  METHODS
  The levels of evidence for each article were evaluated. Statistical analysis of the results was carried out through association parameters including statistical tests and Odds ratios were calculated for each complication when data was available.
  
  
  RESULTS
  We included 32 observational studies that met the inclusion criteria but only four with usable data. We highlighted a combined Odds ratio of respectively 5.35 and 14.71 for major complications in these studies for combined-surgery compared with abdominoplasty alone.
  
  
  CONCLUSIONS
  The results of this systematic review appears in favor of an increase in major complications related to abdominoplasty combined with breast surgery compared to abdominoplasty alone but the level of evidence of included studies is low or moderate. Prospective cohort comparative studies are necessary to provide strong evidence. However, we recommend to avoid this procedure in massive weight loss patients or patients with thromboembolism history.
authors: Service de chirurgie plastique, reconstructrice et chirurgie de la main, CHU de Bordeaux, université Bordeaux Segalen, Bordeaux, France. Electronic address: Audrey.michot1@gmail.com.
authors: A
authors: A
authors: Michot
authors: Service de chirurgie plastique, reconstructrice et chirurgie de la main, CHU de Bordeaux, université Bordeaux Segalen, Bordeaux, France.
authors: J-M
authors: JM
authors: Alet
authors: Service de chirurgie plastique, reconstructrice et chirurgie de la main, CHU de Bordeaux, université Bordeaux Segalen, Bordeaux, France.
authors: P
authors: P
authors: Pélissier
authors: Service de chirurgie plastique et reconstructrice, CHU de Toulouse, université de Rangueil, Toulouse, France.
authors: J-L
authors: JL
authors: Grolleau-Raoux
authors: Service de chirurgie plastique et reconstructrice, CHU de Strasbourg, université de Strasbourg, Strasbourg, France.
authors: F
authors: F
authors: Bodin
authors: Service de chirurgie plastique et reconstructrice, CHU de Toulouse, université de Rangueil, Toulouse, France.
authors: B
authors: B
authors: Chaput
mesh_terms: D061645:Abdominoplasty; D050110:Bariatric Surgery; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D016462:Mammaplasty; D011183:Postoperative Complications / Q000209:etiology* / Q000601:surgery; D012306:Risk
keywords: Abdominoplastie; Abdominoplasty; Bariatric surgery sequelae; Breast surgery; Chirurgie bariatrique; Chirurgie combinée; Chirurgie mammaire; Combined-surgery; Complication; Complications; Morbidity; Morbidité; Revue systématique; Systematic review