title: Incidence and Risk Factors for Major Hematomas in Aesthetic Surgery: Analysis of 129,007 Patients.
abstract: BACKGROUND
  Postoperative hematomas are one of the most frequent complications following aesthetic surgery. Identifying risk factors for hematoma has been limited by underpowered studies from single institution experiences.
  
  
  OBJECTIVE
  To examine the incidence and identify independent risk factors for postoperative hematomas following cosmetic surgery utilizing a prospective, multicenter database.
  
  
  METHODS
  A prospectively enrolled cohort of patients who underwent aesthetic surgery between 2008 and 2013 was identified from the CosmetAssure database. Primary outcome was occurrence of major hematomas requiring emergency room visit, hospital admission, or reoperation within 30 days of the index operation. Univariate and multivariate analysis was used to identify potential risk factors for hematomas including age, gender, body mass index (BMI), smoking, diabetes, type of surgical facility, procedure by body region, and combined procedures.
  
  
  RESULTS
  Of 129,007 patients, 1180 (0.91%) had a major hematoma. Mean age (42.0 ± 13.0 years vs 40.9 ± 13.9 years, P < 0.01) and BMI (24.5 ± 5.0 kg/m2 vs 24.3 ± 4.6 kg/m2, P < 0.01) were higher in patients with hematomas. Males suffered more hematomas than females (1.4% vs 0.9%, P < 0.01). Hematoma rates were higher in patients undergoing combined procedures compared to single procedures (1.1% vs 0.8%, P < 0.01), and breast procedures compared to body/extremity or face procedures (1.0% vs 0.8% vs 0.7%, P < 0.01). On multivariate analysis, independent predictors of hematoma included age (Relative Risk [RR] 1.01), male gender (RR 1.98), the procedure being performed in a hospital setting rather than an office-based setting (RR 1.68), combined procedures (RR 1.35), and breast procedures rather than the body/extremity and face procedures (RR 1.81).
  
  
  CONCLUSIONS
  Major hematoma is the most common complication following aesthetic surgery. Male patients and those undergoing breast or combined procedures have a significantly higher risk of developing hematomas.
  
  
  METHODS
  2.
authors.affiliation: Department of Plastic Surgery, Vanderbilt University, Nashville, TN. Department of Surgery, Division of Plastic Surgery, University of California, Los Angeles, Los Angeles, CA. Private practice, Duluth, GA. Division of Plastic Surgery, University of Alabama, Birmingham, AL; Aesthetic Surgery Journal.
authors.forename: Christodoulos
authors.initials: C
authors.lastname: Kaoutzanis
authors.affiliation: Department of Plastic Surgery, Vanderbilt University, Nashville, TN. Department of Surgery, Division of Plastic Surgery, University of California, Los Angeles, Los Angeles, CA. Private practice, Duluth, GA. Division of Plastic Surgery, University of Alabama, Birmingham, AL; Aesthetic Surgery Journal.
authors.forename: Julian
authors.initials: J
authors.lastname: Winocour
authors.affiliation: Department of Plastic Surgery, Vanderbilt University, Nashville, TN. Department of Surgery, Division of Plastic Surgery, University of California, Los Angeles, Los Angeles, CA. Private practice, Duluth, GA. Division of Plastic Surgery, University of Alabama, Birmingham, AL; Aesthetic Surgery Journal.
authors.forename: Varun
authors.initials: V
authors.lastname: Gupta
authors.affiliation: Department of Plastic Surgery, Vanderbilt University, Nashville, TN. Department of Surgery, Division of Plastic Surgery, University of California, Los Angeles, Los Angeles, CA. Private practice, Duluth, GA. Division of Plastic Surgery, University of Alabama, Birmingham, AL; Aesthetic Surgery Journal.
authors.forename: Nishant
authors.initials: N
authors.lastname: Ganesh Kumar
authors.affiliation: Department of Plastic Surgery, Vanderbilt University, Nashville, TN. Department of Surgery, Division of Plastic Surgery, University of California, Los Angeles, Los Angeles, CA. Private practice, Duluth, GA. Division of Plastic Surgery, University of Alabama, Birmingham, AL; Aesthetic Surgery Journal.
authors.forename: Konrad
authors.initials: K
authors.lastname: Sarosiek
authors.affiliation: Department of Plastic Surgery, Vanderbilt University, Nashville, TN. Department of Surgery, Division of Plastic Surgery, University of California, Los Angeles, Los Angeles, CA. Private practice, Duluth, GA. Division of Plastic Surgery, University of Alabama, Birmingham, AL; Aesthetic Surgery Journal.
authors.forename: Blair
authors.initials: B
authors.lastname: Wormer
authors.affiliation: Department of Plastic Surgery, Vanderbilt University, Nashville, TN. Department of Surgery, Division of Plastic Surgery, University of California, Los Angeles, Los Angeles, CA. Private practice, Duluth, GA. Division of Plastic Surgery, University of Alabama, Birmingham, AL; Aesthetic Surgery Journal.
authors.forename: Christopher
authors.initials: C
authors.lastname: Tokin
authors.affiliation: Department of Plastic Surgery, Vanderbilt University, Nashville, TN. Department of Surgery, Division of Plastic Surgery, University of California, Los Angeles, Los Angeles, CA. Private practice, Duluth, GA. Division of Plastic Surgery, University of Alabama, Birmingham, AL; Aesthetic Surgery Journal.
authors.forename: James C
authors.initials: JC
authors.lastname: Grotting
authors.affiliation: Department of Plastic Surgery, Vanderbilt University, Nashville, TN. Department of Surgery, Division of Plastic Surgery, University of California, Los Angeles, Los Angeles, CA. Private practice, Duluth, GA. Division of Plastic Surgery, University of Alabama, Birmingham, AL; 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; D002648:Child; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data; D005260:Female; D006406:Hematoma / Q000453:epidemiology* / Q000209:etiology; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011183:Postoperative Complications / Q000453:epidemiology* / Q000209:etiology; D011446:Prospective Studies; D019651:Plastic Surgery Procedures / Q000009:adverse effects*; D012086:Reoperation / Q000706:statistics & numerical data*; D012307:Risk Factors; D012737:Sex Factors; D055815:Young Adult