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Outcome Analysis of Combined Lipoabdominoplasty versus Conventional Abdominoplasty

Heller, Justin B. M.D.; Teng, Edward B.S.; Knoll, Bianca I. M.D.; Persing, John M.D.

Plastic and Reconstructive Surgery: May 2008 - Volume 121 - Issue 5 - p 1821-1829
doi: 10.1097/PRS.0b013e31816b1350
COSMETIC: ORIGINAL ARTICLES

Background: Abdominoplasty and liposuction have traditionally been separate procedures. The authors performed a retrospective cohort study to evaluate the outcomes of a novel single-stage approach combining extensive lipoplasty with a modified transverse abdominoplasty.

Methods: One hundred fourteen patients were evaluated for abdominal contouring. Patients were categorized into four groups: group I (n = 20) received abdominal liposuction only, group II (n = 33) traditional W-pattern incision line abdominoplasty, group III (n = 30) modified transverse incision abdominoplasty, and group IV (n = 31) combined procedure involving widely distributed abdominal liposuction accompanied by inverted V-pattern dissection abdominoplasty. Wound complications, patient satisfaction, and revision rates were compared statistically.

Results: Group I (liposuction alone) experienced an overall complication rate of 5 percent; two patients were dissatisfied (10 percent) and underwent further revision with full abdominoplasties. Group II (traditional W-pattern abdominoplasty) had a complication rate of 42 percent, a dissatisfaction rate of 42 percent, and a revision rate of 39 percent. By comparison, group III (modified low transverse abdominoplasty) had a complication rate of 17 percent, a dissatisfaction rate of 37 percent, and a revision rate of 33 percent. Group IV (combined liposuction plus abdominoplasty) had significantly lower complication, dissatisfaction, and revision rates (9, 3, and 3 percent, respectively).

Conclusions: Modified transverse abdominoplasty combined with extensive liposuction and limited paramedian supraumbilical dissection produced fewer complications and less dissatisfaction than did traditional abdominoplasty. This may be attributable to a reduced tension midline closure in the suprapubic region, less lateral undermining in the upper abdomen, and greater preservation of intercostal artery blood flow to the flap.

New Haven, Conn.

From the Section of Plastic Surgery, Yale University School of Medicine.

Received for publication August 5, 2006; accepted November 29, 2006.

The first two authors contributed equally to the production of this article.

Disclosure: None of the authors has any financial interests in the companies producing or distributing products used for this study.

John A. Persing, M.D., Yale Plastic Surgery, 330 Cedar Street, 3rd Floor, Boardman Building, P.O. Box 208041, New Haven, Conn. 06519, john.persing@yale.edu

©2008American Society of Plastic Surgeons