Safety of Lipoabdominoplasty Versus Abdominoplasty: A Systematic Review and Meta-analysis

BACKGROUND

Lipoabdominoplasty is a powerful operation to maintain a youthful physique for aging people, improve body contouring, and remove excess skin caused by massive weight loss. Nonetheless, it is controversial to combine abdominoplasty and liposuction because of the potential for vascular damage of the abdominal flap and increased complications. The purpose of this article was to determine the complication rates of lipoabdominoplasty compared with traditional abdominoplasty.

METHODS

PubMed, EMBASE, and Cochrane databases were searched through July of 2018. Study results were analyzed utilizing a fixed random effects model. The outcomes were expressed as relative risk (RR) and 95% confidence interval. Subgroup analyses were conducted based on complications.

RESULTS

Overall, 17 trials enrolling 14,061 adult patients were searched. Of these patients, 577 (4.1%) developed seroma; 113 (0.8%) experienced hematoma; 783 (5.6%) experienced wound infection, dehiscence, or fat necrosis; 35 (0.2%) developed deep venous thrombosis; and 110 (0.7%) experienced scar deformity. A forest plot revealed fewer complications in the lipoabdominoplasty group than in the traditional abdominoplasty group (RR = 0.85; 95% CI 0.74-0.97; p = 0.017). Subgroup analysis showed that the lipoabdominoplasty group had a lower incidence of hematoma (RR = 0.56; 95% CI 0.36-0.86; p = 0.009) and seroma (RR = 0.69; 95% CI 0.57-0.85; p = 0.000).

CONCLUSIONS

Lipoabdominoplasty is a valuable tool to perfect body shape. This meta-analysis showed no evidence that it was associated with higher rates of complications.

LEVEL OF EVIDENCE III

This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

High-Volume Drainless Lipoabdominoplasty with Progressive Tension Sutures: UK Experience

BACKGROUND

Lipoabdominoplasty is an established technique, but outcomes of high lipoaspirate volumes in large series are lacking. The authors present the UK experience of high-volume, drainless lipoabdominoplasty using progressive deep tension sutures.

METHODS

A total of 286 consecutive patients at a single center underwent drainless lipoabdominoplasty with a lipoaspirate volume of 500 mL or greater between 2017 and 2023. Surgery was performed under total intravenous anesthesia with SAFELipo, MicroAire, and a superwet technique. Abdominoplasty was commenced through a low convex abdominal incision with multilayer rectus plication, and abdominal closure was undertaken with progressive tension sutures. Logistic regression was used to determine the relationship between lipoaspirate volume and 4 primary outcomes: all complications, delayed healing, seroma, and need for revision.

RESULTS

The mean lipoaspirate volume was 2392.4 mL (range, 500 to 5900 mL), and the abdominal tissue resection weight was 1392.0 g (range, 346 to 3802 g). One-third of patients had local complications (minor irregularities, 14.0%; abdominal scar problems, 12.9%; umbilical shape or scar, 4.5%; localized infection, 4.2%; and delayed healing, 3.8%). One patient (0.3%) had a small area of localized necrosis that was managed successfully by further tissue advancement. There was 1 abdominal hematoma and 2 systemic complications (venous thromboembolism, 0.3%; and drug-induced hepatitis, 0.3%). The seroma rate was 3.1%. A total of 16.0% of patients required revision under general anesthesia, and 6.6% under a local anesthetic. There was no significant relationship between the lipoaspirate volume and any of the 4 primary outcome measures.

CONCLUSIONS

High-volume liposuction can be performed safely simultaneously with abdominoplasty. The authors' complication rates are equivalent to or lower than other published data on lipoabdominoplasty, challenging current concepts in body sculpting.

CLINICAL QUESTION/LEVEL OF EVIDENCE

Risk, III.

The Experience and Complications of Lipoabdominoplasty for Chinese Post-bariatric Population

BACKGROUND

The increasing prevalence of bariatric surgeries in China has led to a growing number of patients experiencing massive weight loss and abdominal skin laxity. However, there is a scarcity of reports addressing post-bariatric lipoabdominoplasty in these patients. This study aims to present our clinical experiences with lipoabdominoplasty in post-bariatric patients in China.

METHODS

We performed lipoabdominoplasty on patients who had abdominal skin laxity following bariatric surgery between March 2018 and October 2023. The procedure encompassed abdominal liposuction, plication of the rectus abdominis muscles, umbilical transposition and progressive tension sutures. Complications were recorded and analyzed.

RESULTS

The cohort consisted of 23 post-bariatric patients who underwent lipoabdominoplasty, achieving aesthetically favorable results. The average age at the time of surgery was 31.5 years, and the mean body mass index (BMI) was 25.1 kg/m2.The overall complication rate was 34.8% (8 out of 23 patients), with hypertrophic scar being the most prevalent complication at 30.4%, followed by partial skin necrosis (4.3%).

CONCLUSION

For the Chinese post-bariatric patients, traditional lipoabdominoplasty may be preferred over fleur-de-lis abdominoplasty. The primary complication observed in our patients is hypertrophic scar. Chinese patients experience a lower rate of other complications, potentially attributed to their lower pre-surgery BMI and younger age.

LEVEL OF EVIDENCE IV

This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .