Complication Rates of Lipoabdominoplasty versus Traditional Abdominoplasty in High-Risk Patients

Background: Concerns over the safety of combining extensive liposuction with abdominoplasty in a one-stage lipoabdominoplasty procedure persist. This study reports a comparison of the perfusion-related complication rates between lipoabdominoplasty and traditional abdominoplasty among high-risk patients, those more susceptible to complications secondary to a smoking history or previous significant supraumbilical abdominal scar. Methods: The authors conducted a chart review of 161 patients from the Yale University Cosmetic Clinic who had undergone either lipoabdominoplasty (n = 93) or traditional abdominoplasty (n = 68) between 2004 and 2009. Patients were classified as high-risk patients if they were active smokers or had undergone previous abdominal surgery resulting in a significant supraumbilical abdominal scarring. Specific vascularity-related complications were compared between the techniques. Results: Patients undergoing lipoabdominoplasty had a perfusion-related complication rate of 4.30 percent compared with 11.76 percent in those undergoing traditional abdominoplasty (p = 0.126). Among high-risk patients (26 smokers and 19 patients with significant supraumbilical scars), there was no statistically significant difference for perfusion-related complications, including skin necrosis, wound infection, and wound dehiscence. The need for surgical revision was 10.75 percent in patients undergoing lipoabdominoplasty, whereas 20.58 percent of patients undergoing traditional abdominoplasty needed revision surgery (p = 0.116). Conclusions: Lipoabdominoplasty is not associated with a statistically significant increase in perfusion-related complication rates as compared with traditional abdominoplasty, despite the fact that it involves potential trauma to the vascularity of the elevated abdominoplasty flap. This holds true even in patients who are at increased risk for perfusion-related complications secondary to a history of active smoking or a previous supraumbilical scar. (Plast. Reconstr. Surg. 125: 683, 2010.)