Abdominoplasty, liposuction of the flanks, and obesity: Analyzing risk factors for seroma formation

Background: The purpose of this study was to determine whether seroma formation following abdominoplasty is associated with simultaneous liposuction of the flanks and to stratify the risk of developing seromas according to body mass index. Methods: A retrospective review was conducted of 118 consecutive patients who underwent abdominoplasty with or without flank liposuction from 1992 to 2002. Patients in the abdominoplasty with flank liposuction category were further substratified according to the use of conventional versus ultrasound-assisted liposuction. Data regarding patient age, body mass index, and the Occurrence of seromas were collected and analyzed. Results: Fifteen of the 39 patients who underwent abdominoplasty alone (38 percent) developed seromas. This was comparable to the 23 of 79 patients (29 percent) who developed seromas after abdominoplasty combined with flank liposuction (p = not significant). Eight of 19 patients (42 percent) who had liposuction performed with ultrasound assistance developed seromas, compared with 15 of 60 patients (25 percent) who underwent conventional liposuction without ultrasound (p = not significant). When stratified according to body mass index, overweight or obese patients were more likely to develop seromas than patients of normal weight, whether liposuction was performed in the same setting or not [seromas in seven of 37 (19 percent) of normal weight patients versus 31 of 81 (38 percent) of overweight and obese patients, p < 0.05]. Conclusions: Liposuction of the flanks in concert with abdominoplasty does not appear to increase the risk of seroma formation. Patients who are overweight or obese present a statistically significantly higher risk for developing seromas postoperatively than patients of normal weight.