Outpatient lipoabdominoplasty: review of the literature and practical considerations for safe practice.

BACKGROUND: Lipoabdominoplasty, popularized by Saldanha et al in 2001, is a powerful technique to contour the abdomen and flanks. It has not gained widespread use as concerns exist about increased complications related to wound healing and thromboembolism.

OBJECTIVES: The authors review the existing literature on lipoabdominoplasty and discuss their experiences with the technique in a retrospective case series.

METHODS: A literature search of PubMed/MEDLINE using the search terms lipoabdominoplasty and abdominoplasty was performed by 2 independent investigators. The charts of 85 consecutive patients who underwent lipoabdominoplasty between February 2007 and July 2012 were reviewed.

RESULTS: A combined 1316 lipoabdominoplasty patients had results reported in the literature. Of these patients, 21 of 1316 (1.6%) developed seroma, 5 of 1032 (0.5%) experienced hematoma, 6 of 1032 (0.6%) experienced venous thromboembolism, and 3 of 1032 (0.3%) developed pulmonary embolism. In our case series, all patients were women with an average age of 48 years (range, 27-70 years), average body mass index of 25.2 (17.7-35.5), average follow-up of 8 months (range, 1-54 months), average lipoaspirate of 1605 mL (range, 150-5350 mL), and average weight of resected tissue of 1039 g (range, 128-4838 g). The average operative time was 225 minutes (range, 88-435 minutes), and average time in recovery prior to discharge was 124 minutes (range, 33-270 minutes). Seroma occurred in 20 of 85 patients, 1 patient developed deep venous thrombosis (DVT), 1 patient developed cellulitis, and 1 patient developed an abscess.

CONCLUSION: Lipoabdominoplasty is a safe and effective procedure in appropriately selected patients. Performing the procedure in an outpatient setting requires attention to multiple factors in the perioperative period to ensure safe patient outcomes. Larger prospective studies should be performed to evaluate best practices regarding rare complications such as DVT or pulmonary embolism.