Abdominoplasty in the Obese Patient: Risk versus Reward

Plast Reconstr Surg. 2019 Apr;143(4):721e-726e. doi: 10.1097/PRS.0000000000005413.

Abstract

Background: The incidence of obesity is on the rise worldwide. Many surgeons elect not to perform abdominoplasty on patients with a high body mass index, fearing an increased risk of perioperative complications. In this study, the authors compare the outcomes of obese and nonobese patients who underwent abdominoplasty.

Methods: A retrospective chart analysis was performed on all patients who underwent abdominoplasty by a single surgeon from 2009 to 2016. Complication rates were compared in obese and nonobese patients. Patients were excluded if they did not undergo a full abdominoplasty, underwent a combined surgical procedure, or underwent liposuction in an area outside of the abdomen or flanks at the time of the abdominoplasty.

Results: A total of 83 patients were included: 62 nonobese and 21 obese patients. The obese group had a higher average body mass index (34. 9 kg/m versus 25.1 kg/m; p < 0.001). Follow-up time was similar (310 days versus 265 days; p = 0.468). No significant differences were seen with regard to perioperative seroma formation (14.2 percent versus 22.5 percent; p = 0.419)), wound dehiscence (9.5 percent versus 11.29 percent; p = 0.822), hematoma formation (4.7 percent versus 1.6 percent; p = 0.438), or surgical-site infection (9.5 percent versus 8.0 percent; p = 0.835). No instances of venous thromboembolism were observed.

Conclusions: Abdominoplasty, with or without concurrent liposuction, in obese patients, is a safe and effective procedure with similar perioperative complication rates as the nonobese patient population. No significant differences were observed in perioperative complications.

Clinical question/level of evidence: Risk, II.

Publication types

  • Evaluation Study

MeSH terms

  • Abdominoplasty / methods*
  • Abdominoplasty / statistics & numerical data
  • Adult
  • Drainage / statistics & numerical data
  • Female
  • Hematoma / etiology
  • Humans
  • Lipectomy / statistics & numerical data
  • Male
  • Middle Aged
  • Obesity / surgery*
  • Postoperative Complications / etiology
  • Retrospective Studies
  • Reward
  • Risk Factors
  • Surgical Wound Dehiscence / etiology
  • Surgical Wound Infection / etiology