A Case for the Safety and Efficacy of Lipoabdominoplasty: A Single Surgeon Retrospective Review of 173 Consecutive Cases

Background: The combination of liposuction and abdominoplasty has been slow to be accepted, primarily due to a perceived higher incidence of complications associated with the procedure. There has also been extensive debate about the combined procedure's effects on flap vascularity and viability and the extent to which liposuction may be performed in conjunction with surgical abdominoplasty. Objective: The authors present data from their four-year experience supporting lipoabdominoplasty as a safe and effective procedure for body contouring. Methods: The authors retrospectively reviewed a case series of lipoabdominoplasties performed between 2004 and 2008 by the senior author (KK). A total of 173 consecutive patients who presented for abdominal contouring were included in the study. Each patient underwent a combined procedure beginning with liposuction utilizing the superwet technique, followed by an inverted V-pattern abdominoplasty. Results: Of the patients included in this study, 171 (98.8%) were women and two (1.2%) were men. The average age of the patients was 41.53 years, and the average body mass index was 26. The average amount of total lipoaspirate from the flanks was 2166.09 mL, and the average specimen weight resected was 972.80 g. Complications included partial dehiscence/skin necrosis (12 patients; 6.9%), infection requiring antibiotic therapy and/or intervention (13 patients; 7.5%), suture spitting (one patient; 0.5%), seroma (six patients; 3.4%), major fat necrosis requiring local debridement (one patient; 0.5%), and skin flap necrosis requiring readvancement of the abdominal flap (two patients; 1.1%). There was a revision rate of 8.0%: two patients required additional liposuction to smooth out unevenness, five patients required scar revision, and seven patients had dog-ears requiring intervention. All revisions were performed under local anesthesia. There were also five instances of confirmed deep vein thrombosis (2.8%) and two cases of pulmonary embolism requiring hospitalization (1.1%). Conclusions: The senior author's (KK) lipoabdominoplasty technique, combined with his current preoperative and postoperative protocols, is believed to be a safe procedure that results in excellent cosmetic results. In contrast to some of the current literature, the data show a reduction of overall complications as compared to historical norms.