Clinical Practice Patterns and Evidence-Based Medicine in Abdominoplasty: 16-Year Analysis of Continuous Certification Tracer Data from the American Board of Plastic Surgery

Abstract

Background: The authors evaluated trends in practice patterns for abdominoplasty based on a 16-year review of tracer data collected by the American Board of Plastic Surgery as part of the continuous certification process. Methods: To facilitate comparison of an equal number of patients over time, tracer data from 2005 to 2021 were split into an early cohort (EC) (from 2005 to 2014) and a recent cohort (RC) (from 2015 to 2021). Fisher exact tests and two-sample t tests were used to compare patient demographics, surgical techniques, and complication rates. Results: Data from 8990 abdominoplasties (EC, n = 4740; RC, n = 4250) were analyzed. RC abdominoplasties report a lower rate of complications (RC, 19%; EC, 22%; P < 0.001) and a lower rate of revision surgery (RC 8%; EC, 10%; P < 0.001). This has occurred despite the increased use of abdominal flap liposuction (RC, 25%; EC, 18%; P < 0.001). There has been a decline in the use of wide undermining (81% versus 75%; P < 0.001), vertical plication of the abdomen (89% versus 86%; P < 0.001), and surgical drains (93% versus 89%; P < 0.001). Abdominoplasty surgery is increasingly performed in an outpatient setting, with increased use of chemoprophylaxis for thrombosis prevention. Conclusions: Analysis of these American Board of Plastic Surgery tracer data highlights important trends in clinical practice over the past 16 years. Abdominoplasty continues to be a safe and effective procedure with similar complication and revision rates over the 16-year period.

Measuring Outcomes in Aesthetic Surgery by Board Certified Plastic Surgeons

“…More recently, the American Board of Plastic Surgery continuous certification tracer data have been a source for observing trends in cosmetic procedures; however, these are subject to reporting and selection bias. 26,27 Procedure-or condition-specific complications, such as capsular contracture in breast augmentation, animation deformity, intraabdominal injury with suction-assisted lipectomy, fat embolism in body contouring, or facial nerve injury with rhytidectomy, are difficult to track and risk-stratify on a national level given the range of procedures, technical variations, anatomic areas covered by the specialty, and scarcity of events. Large series in the literature can provide insight, and the establishment of registries that capture procedure-specific and condition-specific clinical data has already started transforming our understanding and management of such occurrences.…”