In 2014, nearly 15.1 million people chose to undergo elective cosmetic procedures. Cosmetic surgical procedures all involve risks, compromises, and complications. Regardless of a physician's efforts to limit complications, spontaneous wound opening or wound dehiscence remains one of the most common to occur. Cosmetic surgery, perhaps more than any other subspecialty of medicine, walks a precarious balance of tension in effort to reduce laxity and elevate ptotic tissues. Historically, dehiscence with wound exposure more than 6.0 hours after spontaneous wound opening is managed conservatively with proper cleansing and dressing changes, with or without empiric antibiotics. Our research sought to determine whether delayed primary closure of a cosmetic wound dehiscence is a safe and viable option to improve patient care and satisfaction. A retrospective case evaluation, patients survey, and statistical evaluation revealed improved satisfaction with delayed primary closure of dehiscent wounds.

The standard of care in abdominal recontouring is complete abdominoplasty. Originally described in 1899 as abdominal lipectomy, the evolution of the procedure has involved rectus plication and application of tension in an effort to improve cosmetic benefits. Resistance to combined lipoaspiration has been fueled by fears of increased complications such as increased rates of ischemia, devascularization, dehiscence, seromas, and higher revision rates. A paucity of evidence supported these fears. We retrospectively reviewed 644 consecutive abdominoplasties performed by one surgeon (E.J.N.) in a facility accredited by the American Association for Ambulatory Healthcare. All patients were American Society of Anesthesiologists (ASA) 1–3.