An Outcomes Analysis and Satisfaction Survey of 199 Consecutive Abdominoplasties

Abstract

Abdominoplasty is a popular body-contouring procedure. In this study the authors review retrospectively 199 abdominoplasty patients during a 15-year period to identify factors that affect overall outcome. Patients included 190 women and 9 men. The complication rate was 32% with few major complications (1.4%). The revision rate was 43%, and was related to fine-tuning the aesthetic appearance. Patients were divided into four groups based on tobacco use and history of diabetes and hypertension. There was no significant difference in revision rates or major complications between the subgroups. Minor complication rates, however, were significantly higher in smokers and patients with diabetes and/or hypertension. Complication and revision rates in patients undergoing intra-abdominal procedures combined with abdominoplasty were not significantly different from those patients undergoing abdominoplasty alone. A patient survey revealed symptom improvement in 95% of patients. Eighty-six percent of patients were satisfied with their result, and 86% would recommend abdominoplasty to a friend. The authors conclude that abdominoplasty is a safe and satisfying procedure, whether performed alone or in conjunction with another procedure. Patients are pleased with the outcome and have improvement in their symptoms, with minimal health risk. There is, however, a significant incidence of minor complications, related primarily to wound healing. These complications are increased significantly in smokers and patients with diabetes and/or hypertension. Revision rates are not different significantly between the subgroups. When complications do occur or revisions are required, they are minor and managed easily in an office setting.

Diabetes: insulin resistance and derangements in lipid metabolism. Cure through intervention in fat transport and storage

“…Animal experiments [102][103][104] and reports in patients [105,106] imply compensatory increases in the size of remaining depots and beneficial metabolic changes after removing amounts of fat varying between 10 and 25%. It has been hypothesized that subcutaneous adipose tissue functions as a 'metabolic sink' accommodating excess energy intake and metabolizing FFA that otherwise detrimentally affect insulin secretion and glucose disposal.…”

Complications after Body Contouring Surgery in Post-Bariatric Patients: The Importance of a Stable Weight Close to Normal

“…Pre-body contouring BMI [2-4, 6, 7], percentage excessive weight loss [5], smoking [8][9][10], diabetes mellitus and/or hypertension [8], nutritional deficiency [11] ASA classification [5], total amount of removed tissue [4,7], intra-operation time, multiple procedures, maximum BMI and change in BMI from maximum to current BMI [12] are mentioned variable as risk factors.…”

Does the tumescent infiltration have an adverse effect on the full abdominoplasty flap?

“…Besides its benefits, abdominoplasty procedure has some complications such as seroma, hematoma, fat necrosis, wound dehiscense and skin necrosis. Both small and large flap necrosis have been mentioned as a minor complication in the literature, resulting in long time follow-up, revisions, unacceptabl scars and sometimes severe problems between the relationship of the surgeon and patient [1][2][3][4][5]. Most of these complications seem to be related with the blood perfusion of the abdominal flap that is divided into 3 vascular territories supplied by the different arterial sources.…”