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Benchmarking Outcomes in Plastic Surgery: National Complication Rates for Abdominoplasty and Breast Augmentation ‘Outcomes Article]

Alderman, Amy K., M.D., M.P.H.; Collins, E Dale, M.D., M.S.; Streu, Rachel, M.D.; Grotting, James C., M.D.; Sulkin, Amy L., M.P.H.; Neligan, Peter, M.D.; Haeck, Phillip C., M.D.; Gutowski, Karol A., M.D.

Plastic and Reconstructive Surgery: December 2009 - Volume 124 - Issue 6 - p 2127-2133
doi: 10.1097/PRS.0b013e3181bf8378

Background: The authors evaluated the use of national databases to track surgical complications among abdominoplasty and breast augmentation patients.

Methods: Their study population included all patients with abdominoplasty or breast augmentation in the Tracking Operations and Outcomes for Plastic Surgeons (TOPS) and CosmetAssure databases from 2003 to 2007. They evaluated the incidence of hematoma, infection, and/or deep venous thrombosis/pulmonary embolism. Chi-square and t tests were used for the analyses.

Results: The TOPS and CosmetAssure databases included 7310 and 3350 patients with abdominoplasty and 30,831 and 14,227 patients with breast augmentation, respectively. In the TOPS and CosmetAssure populations, the complication rates for abdominoplasty were 0.9 percent and 0.5 percent with hematoma (p = 0.29), 3.5 percent and 0.7 percent with infection (p < 0.001), and 0.3 percent and 0.1 percent with deep venous thrombosis/pulmonary embolism (p = 0.05), respectively. The complication rates for breast augmentation in TOPS and CosmetAssure were 0.6 percent and 0.7 percent with hematoma (p = 0.21), 0.3 percent and 0.1 percent with infection (p < 0.001), and 0.02 percent and less than 0.01 percent with deep venous thrombosis/pulmonary embolism (p = 0.31), respectively.

Conclusions: Complication rates for abdominoplasty and breast augmentation were similar in TOPS and CosmetAssure, providing a measure of cross-validation. The low complication rates support the safety of these procedures when they are performed by plastic surgeons. These data should be used by individual practitioners for outcomes benchmarking.

Ann Arbor, Mich.; Hanover, N.H.; Birmingham, Ala.; Madison, Wis.; Chicago, Ill.; Seattle, Wash.; and Evanston, Ill.

From the Section of Plastic Surgery, Department of Surgery, The University of Michigan Medical Center; Department of Surgery, Dartmouth Medical School; Department of General Surgery, St. Joseph Mercy Hospital; Division of Plastic Surgery, The University of Alabama at Birmingham School of Medicine; The University of Wisconsin, Madison; Grotting Plastic Surgery; American Society of Plastic Surgeons; Department of Surgery, University of Washington; private practice; Division of Plastic Surgery, NorthShore University HealthSystem; and the University of Chicago.

Received for publication March 6, 2009; accepted May 7, 2009.

Disclosures:The authors have no financial or commercial interests related to this research except for Dr. Grotting, who is a shareholder of Aesthetic Surgeons Financial Group, LLC, which owns the CosmetAssure trademark.

Amy K. Alderman, M.D., M.P.H., Plastic and Reconstructive Surgery, University of Michigan, 2130 Taubman Center, 500 E. Medical Center Drive, Ann Arbor, Mich. 48109-0340,

©2009American Society of Plastic Surgeons