European Journal of Plastic Surgery

, Volume 42, Issue 5, pp 447–456 | Cite as

Abdominoplasty, seroma formation and duration of hospitalisation: comparative analysis and outcome of 112 consecutive lipoabdominoplasties performed using progressive tension sutures

  • Umar Daraz KhanEmail author
Original Paper



There are conflicting reports that early mobilisation and outpatient-based surgery is associated with higher prevalence of seroma formation. Current comparative retrospective study was carried out to establish whether ambulatory surgery and early mobilisation has an impact on any higher incidence of seroma formation.


A retrospective analysis of 112 cases of consecutive lipoabdominoplasties with progressive tension sutures was carried out. Patients were divided into groups A, B and C.


Group A included 27 patients and were operated as ambulatory cases, with mean age of 36.1 ± 6.98 years and mean BMI of 23.8 ± 3.02. Mean tissue excised was 592 ± 373 g, mean volume of lipoaspirate to abdomen was 352 cc ± 158 and mean 1st 24-h drainage was 26.9 ± 17.24 cc. No patient had seroma. Group B included 68 patients who stayed one night with a mean age of 40.6 ± 11.36 years, mean BMI of 27.4 ± 5.34, tissue excised was 863 ± 544 g, mean volume of lipoaspirate to abdomen was 649 cc ± 510 and mean 1st 24-h drainage was 52.1 ± 58.8 cc. No patient had seroma. Group C included 17 patients who stayed in for two nights as inpatients. Mean age was 38.8 ± 9.66 years, mean body mass index (BMI) of 27.0 ± 4.06. Tissue excised was 927 ± 434 g, mean volume of lipoaspirate was 563 cc ± 316. Mean 1st and 2nd 24-h drainage was 80.1 ± 44.55 cc and 64.8 ± 42.4 cc respectively. No patient had seroma.


Based on the study design, it is possible to conclude that early ambulation most likely did not contribute to seroma formation diagnosed by clinical examination alone in this series.

Level of Evidence IV. Risk/prognostic study.


Abdominoplasty Seroma Lipoabdominoplasty Progressive tension sutures Quilting sutures 


Compliance with ethical standards

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

The research involved the collection or study of existing data, records. The investigator records the data in an anonymous manner such that subjects cannot be identified directly or through identifiers linked to the subject. For this type of retrospective, anonymous data analysis and study, no ethics committee approval was sought.

Conflict of interest

Mr. Umar Daraz Khan declares that he has no conflict of interest.

Informed consent

Informed consent was obtained from all individual participants included in the study.

Patient consent

Patients provided written consent for the use of their images.


The author has not received research funding for this manuscript.


  1. 1.
    Stevens WG, Spring MA, Stoker DA, Cohen R, Vath SD, Hirsch EM (2007) Ten years of outpatients abdominoplasties: safe and effective. Aesthetic Surg J 27:269–275CrossRefGoogle Scholar
  2. 2.
    Pollock TA, Pollock H (2012) Progressive tension sutures in abdominoplasty: a review of 597 consecutive cases. Aesthetic Surg J. 32:729–742CrossRefGoogle Scholar
  3. 3.
    American Society for Aesthetic Plastic Surgery. 2016 statististics, Accessed 21 August 2017
  4. 4.
    Macias LH, Kwon E, Gould DG, Spring MA, Stevens G (2015) Decrease in seroma formation after adopting progressive tension sutures without drains: a single surgery centre experience of 451 abdominoplasties. Aesthetic Surg J. 36:1029–1039CrossRefGoogle Scholar
  5. 5.
    Grazer FM, Goldwyn RM (1977) Abdominoplasty assessed by survey, with emphasis on complications. Plast Reconstr Surg 59:513–517CrossRefGoogle Scholar
  6. 6.
    Somogyi RB, Jamil A, Shih JG, Lista F (2012) Venous thromboembolism in abdominoplasty: a comprehensive approach to lower procedural risk. Aesthetic Surg J. 32:322–329CrossRefGoogle Scholar
  7. 7.
    Dillerud E (1990) Abdominoplasty combined with suction lipoplasty: a study of complications, revisions and risk factors in 487 cases. Ann Plast Surg 25:333–338CrossRefGoogle Scholar
  8. 8.
    Khan UD (2008) Risk of seroma with simultaneous liposuction and abdominoplasty and the role of progressive sutures. Aesthet Plast Surg 32(1):93–100CrossRefGoogle Scholar
  9. 9.
    Seretis K, Goulis D, Demiri EC, Lykoudis EG (2017) Prevention of seroma formation following abdominoplasty: a systemic review and meta-analysis. Aesthetic Surg J. 37:316–323CrossRefGoogle Scholar
  10. 10.
    Jabbour S, Awaida C, Mhawej R, Habre SB, Nasr M (2017) Does the addition of progressive tension sutures to drain reduce seroma incidence after abdominoplasty? A systemic review and meta-analysis. Aesthetic Surg J. 37(4):440–447Google Scholar
  11. 11.
    Kulber DA, BaciliousN PED, Gayle LB, Hoffman L (1997) The use of fibrin sealant in prevention of seromas. Plast Reconstr Surg 99(3):842–849CrossRefGoogle Scholar
  12. 12.
    Lee K-T, Mun G-H (2015) Fibrin sealants and quilting sutures for prevention of seroma formation following latissimus dorsi muscle harvest: a systemic review and a meta-analysis. Aesthet Plast Surg 39:399–409CrossRefGoogle Scholar
  13. 13.
    Nasr MW, Jabbour SF, Mhawej RI, Elkhoury JS, Slelati FH (2016) Effect of tissue adhesive on seroma incidence after abdominoplasty: a systemic review and meta analysis. Aesthetic Surg J. 36(4):450–458CrossRefGoogle Scholar
  14. 14.
    Le Louran C, Pascal JF (2010) The high-superior-tension technique: evolution of lipoabdominoplasty. Aesthet Plast Surg 34(6):773–781CrossRefGoogle Scholar
  15. 15.
    Koller M, Hintringer T (2012) Scarpa fascia or rectus fascia in abdominoplasty flap elevation: a prospective clinical trial. Aesthet Plast Surg 36(2):241–243CrossRefGoogle Scholar
  16. 16.
    Saldanha OR, De Souza Pinto EB, Matos WN Jr et al (2003) Lipoabdominoplasty with selective and safe undermining. Aesthetic Plast Surg J 27:322–327CrossRefGoogle Scholar
  17. 17.
    Baroudi R, Ferreira CAA (1998) Seroma: how to avoid it and how to treat it. Aesthetic Surg J. 18:439–441CrossRefGoogle Scholar
  18. 18.
    Arantes HL, Rosique RG, Rosique MJF, Melega JM (2010) The use of quilting sutures in abdominoplasty does not require aspiratory drainage for prevention of seroma. Aesth Plast Sur 34:102–104CrossRefGoogle Scholar
  19. 19.
    Sforza M, Husein R, Andjelkov K, Rozental-Fernandez PC, Zaccheddu R, Jovanovic M (2015) Use of quilting sutures during abdominoplasty to prevent seroma formation: are they really effective. Aesthetic Surg J. 35(5):574–580CrossRefGoogle Scholar
  20. 20.
    Mladick RA (2001) Progressive tension sutures to reduce complications in abdominoplasty. Plast Reconstr Surg 107:619CrossRefGoogle Scholar
  21. 21.
    Kim J, Stevenson TR (2006) Abdominoplasty, liposuction of the flanks, and obesity: risk factors for seroma formation. Plast Reconstr Surg 117:773–779CrossRefGoogle Scholar
  22. 22.
    Zecha PJ, Missoten FEM (1999) Pseudocyst formation after abdominoplasty – extravasations of Morel-Lavallee. British j of Plast Surg 52:500–502CrossRefGoogle Scholar
  23. 23.
    Pollock H, Pollock T (2000) Progressive tension sutures: a technique to reduce complications in abdominoplasty. Plast Reconstr Surg 56:14–20Google Scholar
  24. 24.
    Keramidas EG, Rodopoulou S, Khan UD (2006) Pseudocyst formation after abdominoplasty combined with liposuction: a case report and review of the literature. Eur J Plast Surg 28:400–402CrossRefGoogle Scholar
  25. 25.
    Khan UD (2012) Seroma formation following abdominoplasty: a retrospective clinical review following three different techniques. Eur J Plast Surg 35(4):299–308CrossRefGoogle Scholar
  26. 26.
    Saldanha O (2006) Lipoabdominoplasty, vol II, Ist edn. Dilivros, Rio de Janeiro, pp 87–91Google Scholar
  27. 27.
    Huger WE Jr (1979) The anatomic rationale for abdominal lipectomy. Am Surg 45:612Google Scholar
  28. 28.
    Matarasso A (1995) Liposuction as an adjunct to a full abdominoplasty. Plast Reconstr Surg 95:829–836CrossRefGoogle Scholar
  29. 29.
    Levesque AY, Daniels MA, Polynice A (2013) Outpatient lipoabdominoplasty: review of the literature and practical considerations for safe practice. Aesthetic Surg J. 33(7):1021–1029CrossRefGoogle Scholar
  30. 30.
    Gray S, Gittleman E, Moliver CL (2012) Safety in office-based full abdominoplast. Aesthetic Surg J. 32(2):200–206CrossRefGoogle Scholar
  31. 31.
    Egrari S (2012) Outpatient-based massive weight loss body contouring: a review of 260 consecutive cases. Aesthetic Surg J. 32(4):474–483CrossRefGoogle Scholar
  32. 32.
    Antonetti JW, Antonetti AR (2010) Reducing seroma in outpatient abdominoplasty: analysis of 516 consecutive cases. Aesthetic Surg J 30(3):418–427CrossRefGoogle Scholar
  33. 33.
    Beer GM, Wallner H (2010) Prevention of seroma after abdominoplasty. Aesthetic Surg J. 30(3):414–417CrossRefGoogle Scholar
  34. 34.
    Mohammad JA, Warnke PH, Stavraky W (1998) Ultrasound in the diagnosis and management of fluid collection complications following abdominoplasty. Ann Plast Surg 41:498–502CrossRefGoogle Scholar
  35. 35.
    Di Martino M, Nahas FX, Barbosa MV, Montecinos Ayaviri NA, Kimura AK, Barella SM, Novo NF, Ferreira LM (2010) Seroma in lipoabdominoplasty and abdominoplasty: a comparative study using ultrasound. Plast Reoconstr Surg 126(5):1742–1751CrossRefGoogle Scholar
  36. 36.
    Epstein S, Epstein MA, Gutowski KA (2015) Lipoabdominoplasty without drains or progressive tension sutures: an analysis of 100 consecutive patients. Aesthet Surg J. 35(4):434–440CrossRefGoogle Scholar
  37. 37.
    Warner JP, Gutowski KA (2009) Abdominoplasty with progressive tension closure using a barbed suture technique. Aesthet Surg J. 29:221–225CrossRefGoogle Scholar
  38. 38.
    Isaac KV, Lista F, McIsaac MP, Ahmad J (2017) Drainless abdominoplasty using barbed progressive tension sutures. Aesthet Surg J. 37(4):428–429CrossRefGoogle Scholar
  39. 39.
    Khan S, Teotia SS, Mullis WF, Jacobs WE, Beasly ME, Smith KL, Eaves FF, Finical SJ, Watterson PA (2006) Do progressive tension sutures really decrease complications in abdominoplasty? Ann Plast Surg 56:14–20CrossRefGoogle Scholar

Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Reshape ClinicWest MallingEngland

Personalised recommendations