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Outcomes of Traditional Cosmetic Abdominoplasty in a Community Setting: A Retrospective Analysis of 1008 Patients

Neaman, Keith C. M.D.; Armstrong, Shannon D. M.D.; Baca, Marissa E. M.D.; Albert, Mark M.D.; Vander Woude, Douglas L. M.D.; Renucci, John D. M.D.

Plastic and Reconstructive Surgery: March 2013 - Volume 131 - Issue 3 - p 403e–410e
doi: 10.1097/PRS.0b013e31827c6fc3
Cosmetic: Original Articles

Background: Abdominoplasty is one of the most commonly performed cosmetic operative procedures. Few large studies have examined outcomes of cosmetic abdominoplasty in a community setting. The authors explored postoperative outcome and the preoperative and intraoperative factors that may contribute to these complications.

Methods: A retrospective review of consecutive patients undergoing abdominoplasty over an 11-year period was performed. Baseline patient demographics, intraoperative technique, and postoperative outcomes were recorded. Preoperative and intraoperative characteristics were analyzed to determine characteristics that predispose patients to complications and undesirable outcomes.

Results: The 1008 study patients underwent either a full or modified abdominoplasty with a total complication rate of 32.6 percent. The most common complication was seroma (15.4 percent). Liposuction of the abdominal flap was performed in 469 patients (46.5 percent) and liposuction of the flanks was performed in 555 patients (55.1 percent). Chi-square analysis followed by logistic regression revealed that liposuction of the flanks and abdomen was independently associated with seroma formation in addition to major and minor complications (p < 0.05).

Conclusions: Seroma formation following abdominoplasty is the most common complication. Concomitant liposuction of the flanks and abdomen with the addition of aggressive undermining leads to higher seroma rates. This association is likely multifactorial and may be secondary to increased resorptive demands placed on the abdominal lymphatics in the setting of greater dead space and larger fluid shifts as a result of liposuction. To reduce seroma rates, surgeons should avoid aggressive liposuction and undermining, particularly in high-risk patients.


Grand Rapids, Mich.

From the Grand Rapids Medical Education and Research Center and the College of Human Medicine, Michigan State University, and Plastic Surgery Associates, P.C.

Received for publication May 21, 2012; accepted September 27, 2012.

Presented at the 56th Annual Meeting of the Plastic Surgery Research Council, in Louisville, Kentucky, April 28 through 30, 2011; the Plastic Surgery Senior Resident's Conference, in Nashville, Tennessee, January 20 through 22, 2011; the 49th Annual Meeting of the Midwestern Association of Plastic Surgeons, in Chicago, Illinois, May 15 through 16, 2010; and the 89th Annual Meeting of the American Association of Plastic Surgeons, in San Antonio, Texas, March 20 through 23, 2010.

Disclosure: The authors have no financial interest to declare in relation to the content of this article.

John D. Renucci, M.D.; Plastic Surgery Associates, Grand Plaza Place, 220 Lyon Street NW, Suite 700, Grand Rapids, Mich. 49503,

©2013American Society of Plastic Surgeons