title: Preoperative Risk Factors and Complication Rates of Thighplasty: Analysis of 1,493 Patients.
abstract: BACKGROUND
  Despite a rise in thighplasties, outcomes and risk factors have not been well described.
  
  
  OBJECTIVE
  This study investigated the incidence and risk factors of major complications following thighplasty in a large, prospective, multicenter database. It further evaluated the safety of combined procedures.
  
  
  METHODS
  Patients undergoing thighplasty between 2008 and 2013 were identified within the CosmetAssure database (Birmingham, AL). The primary outcome was the occurrence of major complication(s) requiring emergency department visit, hospital admission, or reoperation within 30 days postoperatively. Age, gender, body mass index, smoking, diabetes, type of facility, and combination procedures were evaluated as risk factors.
  
  
  RESULTS
  Among the 129,007 patients enrolled in CosmetAssure, 1493 (0.8%) underwent thighplasty. One thousand and eighty-eight (72.9%) thighplasties were combined with other procedures. Ninety-nine (6.6%) developed at least one complication. The most common complications were infection (2.7%), hematoma (2.1%), suspected venous thromboembolism (VTE) (1.1%), fluid overload (0.5%), and confirmed VTE (0.3%). Thighplasties performed in a hospital had higher complications (8.1%) than ambulatory surgical center (6.2%) and office-based surgical suite (3.1%). When thighplasty was performed alone, smoking was an independent risk factor to develop at least one complication (RR = 9.51) and hematoma (RR = 13.48). Compared to thighplasty alone, complication rate did not increase with the addition of concomitant procedures (4.7% vs 7.4%, P = .079).
  
  
  CONCLUSIONS
  Infection and hematoma are the most common major complications. In thighplasty alone, smoking is the only independent risk factor for overall complications and hematoma formation. The addition of concomitant cosmetic procedures does not increase complication rates.
  
  
  METHODS
  2 Risk.
authors.affiliation: Drs Afshari and Nguyen are Plastic Surgery Research Fellows, Drs Gupta and Higdon are Assistant Professors, and Dr Shack is the Chair, Department of Plastic Surgery, Vanderbilt University Medical Center, Nashville, TN. Dr Afshari is also a General Surgery Resident, Department of General Surgery, University of South Carolina, Columbia, SC. Dr Grotting is a Clinical Professor, Division of Plastic Surgery, University of Alabama at Birmingham, Birmingham, AL; and CME/MOC Section Editor for Aesthetic Surgery Journal.
authors.forename: Ashkan
authors.initials: A
authors.lastname: Afshari
authors.affiliation: Drs Afshari and Nguyen are Plastic Surgery Research Fellows, Drs Gupta and Higdon are Assistant Professors, and Dr Shack is the Chair, Department of Plastic Surgery, Vanderbilt University Medical Center, Nashville, TN. Dr Afshari is also a General Surgery Resident, Department of General Surgery, University of South Carolina, Columbia, SC. Dr Grotting is a Clinical Professor, Division of Plastic Surgery, University of Alabama at Birmingham, Birmingham, AL; and CME/MOC Section Editor for Aesthetic Surgery Journal.
authors.forename: Varun
authors.initials: V
authors.lastname: Gupta
authors.affiliation: Drs Afshari and Nguyen are Plastic Surgery Research Fellows, Drs Gupta and Higdon are Assistant Professors, and Dr Shack is the Chair, Department of Plastic Surgery, Vanderbilt University Medical Center, Nashville, TN. Dr Afshari is also a General Surgery Resident, Department of General Surgery, University of South Carolina, Columbia, SC. Dr Grotting is a Clinical Professor, Division of Plastic Surgery, University of Alabama at Birmingham, Birmingham, AL; and CME/MOC Section Editor for Aesthetic Surgery Journal.
authors.forename: Lyly
authors.initials: L
authors.lastname: Nguyen
authors.affiliation: Drs Afshari and Nguyen are Plastic Surgery Research Fellows, Drs Gupta and Higdon are Assistant Professors, and Dr Shack is the Chair, Department of Plastic Surgery, Vanderbilt University Medical Center, Nashville, TN. Dr Afshari is also a General Surgery Resident, Department of General Surgery, University of South Carolina, Columbia, SC. Dr Grotting is a Clinical Professor, Division of Plastic Surgery, University of Alabama at Birmingham, Birmingham, AL; and CME/MOC Section Editor for Aesthetic Surgery Journal.
authors.forename: R Bruce
authors.initials: RB
authors.lastname: Shack
authors.affiliation: Drs Afshari and Nguyen are Plastic Surgery Research Fellows, Drs Gupta and Higdon are Assistant Professors, and Dr Shack is the Chair, Department of Plastic Surgery, Vanderbilt University Medical Center, Nashville, TN. Dr Afshari is also a General Surgery Resident, Department of General Surgery, University of South Carolina, Columbia, SC. Dr Grotting is a Clinical Professor, Division of Plastic Surgery, University of Alabama at Birmingham, Birmingham, AL; and CME/MOC Section Editor for Aesthetic Surgery Journal.
authors.forename: James C
authors.initials: JC
authors.lastname: Grotting
authors.affiliation: Drs Afshari and Nguyen are Plastic Surgery Research Fellows, Drs Gupta and Higdon are Assistant Professors, and Dr Shack is the Chair, Department of Plastic Surgery, Vanderbilt University Medical Center, Nashville, TN. Dr Afshari is also a General Surgery Resident, Department of General Surgery, University of South Carolina, Columbia, SC. Dr Grotting is a Clinical Professor, Division of Plastic Surgery, University of Alabama at Birmingham, Birmingham, AL; and CME/MOC Section Editor for Aesthetic Surgery Journal.
authors.forename: K Kye
authors.initials: KK
authors.lastname: Higdon
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D015992:Body Mass Index; D002648:Child; D002675:Child, Preschool; D015897:Comorbidity; D016208:Databases, Factual / Q000706:statistics & numerical data; D003920:Diabetes Mellitus / Q000453:epidemiology; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology*; D057234:Preoperative Period; D011446:Prospective Studies; D012307:Risk Factors; D012737:Sex Factors; D012907:Smoking / Q000453:epidemiology; D013518:Surgery, Plastic; D013848:Thigh / Q000601:surgery*; D055815:Young Adult