Methods to Successfully Combine Breast Surgery and Abdominoplasty

Background

Abdominoplasty and breast surgery are appealing to patients as combined procedures.  Performing these operations simultaneously yields decreased cost, a single recovery period, increased convenience, and expedited gratification. The combination dictates meticulous planning at all stages and fastidious attention to detail. Here, we discuss issues pertinent to the safe and effective execution of these procedures in concert.  

Methods

A review of the literature from the origins of combined abdominoplasty to the present state of the art was conducted.  The senior author’s experience with combined abdominoplasty and breast surgery was considered.  These analyses together contribute to recommendations for success in combined abdominoplasty and breast surgery.

Results

Abdominoplasty was initially combined with other procedures in the context of intra-abdominal or gynecologic surgery.  Concern first focused on ensuring safety and minimizing local (e.g. wound healing) complications.  As surgeons began combining abdominoplasty with distant procedures such as breast surgery, additional concerns with systemic morbidity arose, with an emphasis on venous thromboembolism (VTE) prevention.  In our experience, abdominoplasty is performed in conjunction with other procedures more frequently than it is performed in isolation. The combination of abdominoplasty and breast surgery is reasonable with careful patient selection and if specific pre-, intra-, and post-operative guidelines are considered.  Preoperative practices focus on medical optimization.  Intraoperative attention is dedicated to excellent team dynamics and a logical operative plan to maximize outcomes and minimize operative time.  Postoperative care emphasizes early mobilization and vigilance for signs of impending difficulty.

Conclusions

Abdominoplasty and breast surgery are being performed simultaneously with increasing frequency, and the “mommy makeover” has entered the vernacular.  The recommendations in this report aim to allow for the safe and successful execution of these commonly combined procedures.