The Safety and Effects of Pregnancy after Abdominoplasty: A Systematic Review of the Literature

Surprise Baby: Abdominoplasty Performed During Unknown Pregnancy

Abdominoplasty is a commonly performed procedure for patients after significant weight loss and in postpregnancy women. Stable weight and completed family planning are critical for optimal outcomes, as pregnancy postabdominoplasty can increase risks for both mother and fetus and potentially compromise aesthetic results. We present the first reported case of a patient undergoing abdominoplasty while unknowingly pregnant. A 40-year-old woman, 4 years postbariatric bypass surgery, presented for abdominoplasty with a body mass index of 28 kg/m2. She had 3 children and had concluded her family planning. The surgery was performed without complications. Four months later, an unexpected pregnancy at 24 weeks was discovered. The patient developed gestational diabetes and hypertension but had no complications related to the abdominoplasty. The male newborn, delivered at 38 weeks, was small for gestational age but healthy. Ten years postsurgery, the patient maintained excellent aesthetic results with no abdominal complications. This case highlights that although family planning completion is recommended preoperatively to avoid complications, pregnancy postabdominoplasty can still result in favorable maternal and fetal outcomes. Although performing abdominoplasty on pregnant women is not advised, this case demonstrates that an undetected pregnancy during the procedure did not lead to adverse outcomes for the mother or child.

Pregnancy After Panniculectomy Postbariatric Surgery: A Case Report

Panniculectomy and abdominoplasty are two forms of abdominal body contouring commonly performed. There are literature reports of healthcare providers citing abdominoplasty as a contraindication to future pregnancy due to potential risks to the patient and fetus. Panniculectomy, outside of the reduced risks from the lack of rectus muscle plication, would have similar effects on the patient and fetus in future pregnancies. Yet, abdominal contouring surgery is being performed in women of childbearing age with increasing frequency, meriting further research to explore the true safety profile of pregnancy after body contouring surgeries. Here, we present a case report of a woman who underwent two full-term vaginal deliveries after undergoing a panniculectomy due to massive weight loss from prior gastric bypass. While she had high utilization of healthcare services throughout her pregnancies, she experienced no significant adverse pregnancy outcomes. Our report is consistent with current literature, suggesting that prior panniculectomy should not be a contraindication to pregnancy.

Perinatal outcomes following abdominoplasty: a retrospective study and review of current literature

BACKGROUND

Abdominoplasty surgery is a common body contouring surgery to remove excess fat and skin and restore weakened or separated abdominal muscles caused by aging, pregnancy, or weight fluctuations. There is limited literature regarding patient and pregnancy outcomes after abdominoplasty.

OBJECTIVE

This study aimed to determine whether there was a correlation between adverse pregnancy outcomes and history of abdominoplasty.

STUDY DESIGN

Our study used a large federated deidentified national health research network with data sourced from 68 healthcare organizations within the United States (TriNetX; data accessed on August 19, 2022). All patients with a record of pregnancy were identified using the International Classification of Diseases, Ninth Revision and Tenth Revision, codes and were grouped into those with a history of abdominoplasty and those without. This study evaluated the perinatal outcomes of fetal growth restriction, abnormal umbilical artery Dopplers, gestational hypertension, preeclampsia, preterm delivery, preterm premature rupture of membranes, gestational diabetes mellitus, macrosomia, stillbirth, abnormal placentation, and wound disruption or infection occurring during a patient's pregnancy after abdominoplasty. Propensity matching was performed to account for potential confounders. An alpha level of <.05 was considered statistically significant.

RESULTS

Of the 44,737 patients meeting our criteria, 304 had a history of abdominoplasty, whereas 44,433 did not (control). Our study found that patients with a history of abdominoplasty had significantly higher gravidity, were largely located in the Southern and Midwest region, and had higher counts of vaginal deliveries and cesarean deliveries than the control cohort (Table 1). After propensity score matching, our study found a lower risk of preeclampsia and preterm premature rupture of membranes in patients with abdominoplasty (odds ratio, 0.46; 95% confidence interval, 0.32-0.67; P<.0001) (Table 2). Furthermore, abdominoplasty was associated with an increased risk of preterm delivery (odds ratio, 2.15; 95% confidence interval, 1.48-3.13; P=.0002) (Table 2). Lastly, this study did not find significant differences in the other perinatal outcomes (Table 2).

CONCLUSION

Our data suggest that abdominoplasty may be associated with a relative increase in the rates of preterm delivery and cesarean delivery and that other perinatal outcomes are not increased. This provides evidence that future desire for pregnancy need not be a relative contraindication to abdominoplasty.