Is There A Limit? A Risk Assessment Model Of Liposuction And Lipoaspirate Volume On Morbidity Following Abdominoplasty
Brittany Vieira, B.S.1, Ian Chow, M.D.1, Phillip Hanwright, MD2, Sammy Sinno, M.D.3, Robert Dorfman, M.Sc.1, Karol Gutowski, M.D.4.
1Northwestern Univeristy Feinberg School of Medicine, Chicago, IL, USA, 2Department of Plastic and Reconstructive Surgery, Johns Hopkins University School of Medicine, Baltimor, MD, USA, 3Hansjörg Wyss Department of Plastic Surgery, New York University Langone Medical Center, New York, NY, USA, 4Division of Plastic and Reconstructive Surgery, Department of Surgery, University of Illinois - Chicago,, Chicago, IL, USA.
Purpose: Combined liposuction and abdominoplasty is a common procedure but is controversial due to concerns for increased complications. Because of this, the lipoaspirate volume in abdominoplasty has been a topic of legislative regulations. This study aims to evaluate complication rates in abdominoplasty performed with and without abdominal liposuction, as well as evaluate the effect of lipoaspirate volumes on complications.
Methods: Abdominoplasties and suction-assisted lipectomies of the trunk were identified in the Tracking Operations and Outcomes for Plastic Surgeons database. Multivariate regressions were used to determine the effect of concomitant liposuction in abdominoplasty, as well as determine the effect of liposuction volume on complications. In light of recently proposed thresholds, multiple limits in liposuction were evaluated.
Results: 11,191 patients met inclusion criteria with 9,638(86.1%) patients undergoing abdominoplasty with truncal liposuction and 1,553(13.9%) undergoing abdominoplasty alone. Corresponding overall complication rates were 10.5% and 13.0%. Combined liposuction and abdominoplasty was independently associated with a reduced likelihood of both overall complications (p=0.046) and seroma (p=0.030). Given existing laws limiting liposuction volume to 500 or 1,000mL, each of these thresholds were evaluated with no effect on complications. Surprisingly, increasing lipoaspirate volume was not independently associated with an increased risk of any complication.
Conclusions: Abdominoplasty with truncal liposuction is a safe procedure with a lower rate of complications than abdominoplasty alone. Current regulations governing liposuction volumes in abdominoplasty are arbitrary and do not reflect valid thresholds for increased complications. Trunk liposuction and abdominoplasty is safe, with no significant risk of increased morbidity from increasing liposuction volumes.
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