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Aesthetic Plastic Surgery

, Volume 43, Issue 1, pp 167–174 | Cite as

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

  • YiJun Xia
  • Jun Zhao
  • Dong Sheng CaoEmail author
Systemic Review Body Contouring
  • 148 Downloads

Abstract

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.

Keywords

Lipoabdominoplasty Complication Abdominoplasty Meta-analysis 

Notes

Compliance with Ethical Standards

Conflict of interest

The authors certify that no competing interests exist.

References

  1. 1.
    El-Mrakby HH, Milner RH (2002) The vascular anatomy of the lower anterior abdominal wall: a microdissection study on the deep inferior epigastric vessels and the perforator branches. Plast Reconstr Surg 1092:539–543 (discussion 537–544) CrossRefGoogle Scholar
  2. 2.
    Epstein S, Epstein MA, Gutowski KA (2015) Lipoabdominoplasty without drains or progressive tension sutures: an analysis of 100 consecutive patients. Aesthet Surg J 354:434–440CrossRefGoogle Scholar
  3. 3.
    Espinosa-de-los-Monteros A, de la Torre JI, Rosenberg LZ et al (2006) Abdominoplasty with total abdominal liposuction for patients with massive weight loss. Aesthet Plast Surg 301:42–46CrossRefGoogle Scholar
  4. 4.
    Gould DJ, Macias LH, Saeg F et al (2018) Seroma rates are not increased when combining liposuction with progressive tension suture abdominoplasty: a retrospective cohort study of 619 patients. Aesthet Surg J 387:763–769CrossRefGoogle Scholar
  5. 5.
    Gravante G, Araco A, Sorge R et al (2008) Pulmonary embolism after combined abdominoplasty and flank liposuction: a correlation with the amount of fat removed. Ann Plast Surg 606:604–608CrossRefGoogle Scholar
  6. 6.
    Heller JB, Teng E, Knoll BI, Persing J (2008) Outcome analysis of combined lipoabdominoplasty versus conventional abdominoplasty. Plast Reconstr Surg 1215:1821–1829CrossRefGoogle Scholar
  7. 7.
    Hosseini SN, Ammari A, Mousavizadeh SM (2018) Correcting flank skin laxity and dog ear plus aggressive liposuction: a technique for classic abdominoplasty in Middle-Eastern obese women. World J Plast Surg 71:78–88Google Scholar
  8. 8.
    Hutton B, Salanti G, Caldwell DM et al (2015) The PRISMA extension statement for reporting of systematic reviews incorporating network meta-analyses of health care interventions: checklist and explanations. Ann Intern Med 16211:777–784CrossRefGoogle Scholar
  9. 9.
    Kanjoor JR, Singh AK (2012) Lipoabdominoplasty: an exponential advantage for a consistently safe and aesthetic outcome. Indian J Plast Surg 451:77–88CrossRefGoogle Scholar
  10. 10.
    Khan LR, Raine CR, Dixon JM (2017) Immediate lipofilling in breast conserving surgery. Eur J Surg Oncol 438:1402–1408CrossRefGoogle Scholar
  11. 11.
    Kim J, Stevenson TR (2006) Abdominoplasty, liposuction of the flanks, and obesity: analyzing risk factors for seroma formation. Plast Reconstr Surg 1173:773–779 (discussion 771–780) CrossRefGoogle Scholar
  12. 12.
    Kim JK, Jang JY, Hong YG et al (2016) Deep-plane lipoabdominoplasty in East Asians. Arch Plast Surg 434:352–359CrossRefGoogle Scholar
  13. 13.
    Lockwood T (1995) High-lateral-tension abdominoplasty with superficial fascial system suspension. Plast Reconstr Surg 963:603–615CrossRefGoogle Scholar
  14. 14.
    Lockwood TE (2004) Maximizing aesthetics in lateral-tension abdominoplasty and body lifts. Clin Plast Surg 314(523–537):vGoogle Scholar
  15. 15.
    Macias LH, Kwon E, Gould DJ et al (2016) Decrease in seroma rate after adopting progressive tension sutures without drains: a single surgery center experience of 451 abdominoplasties over 7 years. Aesthet Surg J 369:1029–1035CrossRefGoogle Scholar
  16. 16.
    Margulis AV, Pladevall M, Riera-Guardia N et al (2014) Quality assessment of observational studies in a drug-safety systematic review, comparison of two tools: the Newcastle–Ottawa Scale and the RTI item bank. Clin Epidemiol 6:359–368CrossRefGoogle Scholar
  17. 17.
    Matarasso A (1991) Abdominolipoplasty: a system of classification and treatment for combined abdominoplasty and suction-assisted lipectomy. Aesthet Plast Surg 152:111–121CrossRefGoogle Scholar
  18. 18.
    Neaman KC, Armstrong SD, Baca ME et al (2013) Outcomes of traditional cosmetic abdominoplasty in a community setting: a retrospective analysis of 1008 patients. Plast Reconstr Surg 1313:403e–410eCrossRefGoogle Scholar
  19. 19.
    Pollock H, Pollock T (2000) Progressive tension sutures: a technique to reduce local complications in abdominoplasty. Plast Reconstr Surg 1057:2583–2586 (discussion 2587–2588) CrossRefGoogle Scholar
  20. 20.
    Razzano S, Gathura EW, Sassoon EM et al (2016) Scarpa fascia preservation in abdominoplasty: does it preserve the lymphatics? Plast Reconstr Surg 1375:898e–899eCrossRefGoogle Scholar
  21. 21.
    Rieger UM, Erba P, Wettstein R et al (2008) Does abdominoplasty with liposuction of the love handles yield a shorter scar? an analysis with abdominal 3D laser scanning. Ann Plast Surg 614:359–363CrossRefGoogle Scholar
  22. 22.
    Roostaeian J, Harris R, Farkas JP et al (2014) Comparison of limited-undermining lipoabdominoplasty and traditional abdominoplasty using laser fluorescence imaging. Aesthet Surg J 345:741–747CrossRefGoogle Scholar
  23. 23.
    Saldanha OR, Federico R, Daher PF et al (2009) Lipoabdominoplasty. Plast Reconstr Surg 1243:934–942CrossRefGoogle Scholar
  24. 24.
    Saldanha OR, Azevedo SF, Delboni PS et al (2010) Lipoabdominoplasty: the Saldanha technique. Clin Plast Surg 373:469–481CrossRefGoogle Scholar
  25. 25.
    Samra S, Sawh-Martinez R, Barry O, Persing JA (2010) Complication rates of lipoabdominoplasty versus traditional abdominoplasty in high-risk patients. Plast Reconstr Surg 1252:683–690CrossRefGoogle Scholar
  26. 26.
    Seth AK, Lin AM, Austen WG Jr et al (2017) Impact of patient subtype and surgical variables on abdominoplasty outcomes: a 12-year Massachusetts General Hospital experience. Plast Reconstr Surg 1405:899–908CrossRefGoogle Scholar
  27. 27.
    Smith LF, Smith LF Jr (2015) Safely combining abdominoplasty with aggressive abdominal liposuction based on perforator vessels: technique and a review of 300 consecutive cases. Plast Reconstr Surg 1355:1357–1366CrossRefGoogle Scholar
  28. 28.
    Swanson E (2013) Prospective clinical study of 551 cases of liposuction and abdominoplasty performed individually and in combination. Plast Reconstr Surg Glob Open 15:e32CrossRefGoogle Scholar
  29. 29.
    van Uchelen JH, Werker PM, Kon M (2001) Complications of abdominoplasty in 86 patients. Plast Reconstr Surg 1077:1869–1873CrossRefGoogle Scholar
  30. 30.
    Vera Cucchiaro J, Lostia H, Velazquez P, Liska E (2017) Lipoabdominoplasty with progressive traction sutures. Plast Reconstr Surg Glob Open 56:e1338CrossRefGoogle Scholar
  31. 31.
    Vieira BL, Chow I, Sinno S et al (2018) Is there a limit? a risk assessment model of liposuction and lipoaspirate volume on complications in abdominoplasty. Plast Reconstr Surg 1414:892–901CrossRefGoogle Scholar
  32. 32.
    Villegas FJ (2014) A novel approach to abdominoplasty: TULUA modifications (transverse plication, no undermining, full liposuction, neoumbilicoplasty, and low transverse abdominal scar). Aesthet Plast Surg 383:511–520CrossRefGoogle Scholar
  33. 33.
    Weiler J, Taggart P, Khoobehi K (2010) A case for the safety and efficacy of lipoabdominoplasty: a single surgeon retrospective review of 173 consecutive cases. Aesthet Surg J 305:702–713CrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature and International Society of Aesthetic Plastic Surgery 2018

Authors and Affiliations

  1. 1.Department of Plastic and Reconstructive Surgery, The Second Affiliated HospitalAnhui Medical UniversityHefeiChina

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