Abdominoplasty in the Overweight and Obese Population: Outcomes and Patient Satisfaction

Abstract

Background: Abdominoplasty is a safe, efficacious body contouring procedure commonly performed on patients after massive weight loss or pregnancy, or because of general aging. However, complication rates and patient satisfaction levels remain largely unexplored for the overweight and obese patient population. The purpose of this study was twofold: to determine the complication rate and to gauge the psychological impact of abdominoplasty in the overweight or obese patient. Methods: A retrospective review was conducted of consecutive overweight and obese patients undergoing abdominoplasty or panniculectomy over a 12-year period from January of 2004 to December of 2016. Patient medical records were reviewed to identify patient demographics and comorbidities, operative details, and postoperative course. A patient survey was used to assess satisfaction, personal experience with complications, and the recovery process. Results: Forty-six total patients underwent abdominoplasty or panniculectomy during the 12-year period and met the criterion of body mass index greater than or equal to 25 kg/m2. The average patient body mass index was 32.0 kg/m2, with the majority of the patients categorized as overweight. The average abdominal resection weight was 4834.9 g. Major complications, defined as complications requiring return to the operating room, occurred in four patients (8.7 percent). Minor complications, defined as complications that could be handled in an office setting, occurred in 18 patients (39.1 percent). Thirty-six patients (78.3 percent) responded to the survey. The overwhelming majority of patients who responded to the survey [n = 35 (97.2 percent)] stated that they were satisfied with the final outcome and would choose to have the procedure again. Conclusion: Abdominoplasty and panniculectomy in overweight and obese patients are associated with an elevated complication rate, yet patient satisfaction is overwhelmingly high, suggesting the viability of body contouring procedures in this patient population. CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, IV.

Impact of Panniculectomy and/or Abdominoplasty on Quality of Life: A Retrospective Cohort Analysis of Patient Reported Outcomes”

“…4 In contrast, improvement was seen in all domains of the BODY-Q after abdominal body contouring procedures, including satisfaction with abdomen and satisfaction with body. Adverse outcomes did not affect the positive effects of abdominal body contouring procedures on quality of life in our cohort, substantiated by a previous report by Hammond et al 20 These data may be used to counsel patients and to help set expectations preoperatively. We also highlight important public health implications.…”

“…Previous studies that demonstrated overall improvement in quality of life after body contouring procedures further substantiate these data. 2,14–16 Arthurs et al 2 and Hammond et al 20 described subjective improvement after panniculectomy in postbariatric patients. Modarressi et al 14 found that body contouring procedures significantly improve patients’ quality of life in all domains when compared with patients solely undergoing gastric bypass.…”

Clinical Outcome of Abdominoplasty Cases—A Five-Year Retrospective Study

“…[15] Hammond et al performed abdominoplasty on patient with an average BMI of 32 kg/m 2 and had major and minor complications in 47.8% of the cases. [16] In the first 2 years of our study we were performing abdominoplasty in patients with BMI above 28 Kg/m 2 and we had complication rate of 21.2% in these patients. We decided in the last 3 years of the study to restrict the abdominoplasty procedure to those who have BMI of 28 Kg/m 2 or less and the incidence of complications reduced to 14.3% in this category.…”

Standards and Trends in Lipoabdominoplasty

“…Hammond et al found 8% rate of major complications requiring return to the OR and 39.1% risk of minor complications that were managed conservatively in a series of 46 overweight and obese patients (mean BMI = 32 kg/m). 62 Patients reported high satisfaction with the overall appearance of their abdomen post-operatively. Although both studies were significantly limited by small statistical power, they suggest that the growing trend of lipoabdominoplasty procedures in overweight and obese populations can be performed safely and with satisfactory results.…”