Abdominoplasty: Risk Factors, Complication Rates, and Safety of Combined Procedures.
BACKGROUND
Among aesthetic surgery procedures, abdominoplasty is associated with a higher complication rate, but previous studies are limited by small sample sizes or single-institution experience.


METHODS
A cohort of patients who underwent abdominoplasty between 2008 and 2013 was identified from the CosmetAssure database. Major complications were recorded. Univariate and multivariate analysis was performed evaluating risk factors, including age, smoking, body mass index, sex, diabetes, type of surgical facility, and combined procedures.


RESULTS
The authors identified 25,478 abdominoplasties from 183,914 procedures in the database. Of these, 8,975 patients had abdominoplasty alone and 16,503 underwent additional procedures. The number of complications recorded was 1,012 (4.0 percent overall rate versus 1.4 percent in other aesthetic surgery procedures). Of these, 31.5 percent were hematomas, 27.2 percent were infections and 20.2 percent were suspected or confirmed venous thromboembolism. On multivariate analysis, significant risk factors (p < 0.05) included male sex (relative risk, 1.8), age 55 years or older (1.4), body mass index greater than or equal to 30 (1.3), multiple procedures (1.5), and procedure performance in a hospital or surgical center versus office-based surgical suite (1.6). Combined procedures increased the risk of complication (abdominoplasty alone, 3.1 percent; with liposuction, 3.8 percent; breast procedure, 4.3 percent; liposuction and breast procedure, 4.6 percent; body-contouring procedure, 6.8 percent; liposuction and body-contouring procedure, 10.4 percent).


CONCLUSIONS
Abdominoplasty is associated with a higher complication rate compared with other aesthetic procedures. Combined procedures can significantly increase complication rates and should be considered carefully in higher risk patients.


METHODS
Risk, II.
Nashville, Tenn.; and Birmingham, Ala. From the Department of Plastic Surgery, Vanderbilt University; and the Department of Plastic Surgery, University of Alabama.
Julian
J
Winocour
Varun
V
Gupta
J Roberto
JR
Ramirez
R Bruce
RB
Shack
James C
JC
Grotting
K Kye
KK
Higdon
D061645:Abdominoplasty / Q000009:adverse effects* / Q000379:methods; D000328:Adult; D000367:Age Factors; D000704:Analysis of Variance; D015992:Body Mass Index; D016009:Chi-Square Distribution; D015331:Cohort Studies; D003131:Combined Modality Therapy; D016208:Databases, Factual; D004954:Esthetics; D005260:Female; D005500:Follow-Up Studies; D006406:Hematoma / Q000453:epidemiology* / Q000209:etiology; D006801:Humans; D015994:Incidence; D015187:Lipectomy / Q000009:adverse effects / Q000379:methods; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000175:diagnosis / Q000601:surgery; D061214:Patient Safety; D011183:Postoperative Complications / Q000453:epidemiology / Q000503:physiopathology; D011446:Prospective Studies; D012307:Risk Factors; D012737:Sex Factors; D013530:Surgical Wound Infection / Q000453:epidemiology* / Q000209:etiology / Q000503:physiopathology; D013923:Thromboembolism / Q000453:epidemiology* / Q000209:etiology; D016896:Treatment Outcome