Manhattan Eye, Ear, &Throat Hospital, New York, NY, USA.
PURPOSE
The purpose of this study was to assess current trends in abdominal contouring techniques, associated procedures and the incidence of their complications. Multiple surgical techniques are available to the plastic surgeon for abdominal contouring. They include: liposuction, the limited and full abdominoplasty. According to the ASPS’ 2003 Cosmetic Surgery National Data Bank, during the last 6 years abdominoplasty procedures increased 246%. A national report on abdominoplasty has not been reported since 1977. Grazer and Goldwyn study reflects the pre-liposuction era of abdominal contouring surgery.
METHODS
The study design was descriptive, correlation survey that evaluated the frequency of various abdominal contour techniques and complications performed by Board Certified Plastic Surgeons. IRB approval was obtained. A survey was mailed to 3,300 randomly selected members of the American Society of Plastic Surgeons.
RESULTS
Respondents numbered 497 for a response rate of 15%. Of the 20,029 procedures reported in this survey, 35% (7,010) were liposuction of the abdomen, 10% (2,003) were limited abdominoplasty and 55% (11,016) were full abdominoplasty. Data on the plastic surgeons’ demographics and techniques are reported. Local and systemic complications are reported in Tables I and II, respectively.
| Table 1: Local Abdominal Contour Surgery Complications |
| Complications | Liposuction | Limited Abdominoplasties | Full Abdominoplasties |
| Contour Irregularity | 9.20% | 4.90% | 5% |
| Major Skin Necrosis (Requiring Re-Operation) | 0% | 1% | 1% |
| Minor Skin Necrosis (Heals Spontaneously) | 0% | 4% | 4.40% |
| Scar Revision | 0.03% | 2.40% | 4.90% |
| Hematoma | 0.04% | 0.08% | 1.40% |
| Wound Infection | 1% | 0.02% | 1.10% |
| Wound Dehiscence | 0% | 1% | 1% |
| Umbilical abnormality (Requiring Re-Operation) | 0% | 0.05% | 1.20% |
| Dissatisfied Patients (Unfulfilled Expectations) | 3.30% | 2.90% | 2.20% |
| Need for Second Surgery | 3.50% | 2.40% | 3.40% |
| Table 2: Systemic Abdominal Contour Surgery Complications |
| Complications | Liposuction | Limited Abdominoplasties | Full Abdominoplasties |
| Local Anesthesia (i.e. Wetting Solution) | 0% | 0% | 0% |
| Major Anesthesia | 0% | 0% | 0% |
| Malpractice Action | 0% | 0% | 0.01% |
| Blood Transfusion | 0% | 0.01% | 0.04% |
| Deep Vein Thrombophlebitis (DVT) | 0% | 0% | 0.04% |
| Pulmonary Embolism | 0% | 0% | 0.02% |
| Pulmonary Fat Embolism | 0% | 0% | 0% |
| Intra-Abdominal Perforation | 0% | 0% | 0% |
| Deaths | 0% | 0% | 0% |
| Re-Admission to Hospital | 0.01% | 0.01% | 0.05% |
CONCLUSIONS
We reported on the current abdominal contour surgery experience of 497 Board Certified Plastic Surgeons who performed 20,029 procedures. In the 55% of the patients having a full abdominoplasty (n=11,016) we report one of the largest series of complications and find that despite the more extensive techniques and the addition of liposuction, that complications are similar to previous reports. We found that there was no correlation between surgery years in practice and complications rates as did Grazer and Goldwyn’s abdominoplasty survey in 1977.