Purpose:
Although it is a common practice to combine elective breast surgery with abdominoplasty, there is a surprising paucity of current published information on this topic. This study was designed to evaluate and compare the complication rate of patients having abdominoplasty without breast surgery to those having abdominoplasty with various types of elective breast surgery including breast augmentation, breast reduction, mastopexy, and mastopexy combined with simultaneous augmentation. Removal and replacement of implants, and capsulectomy/capsulotomy procedures were included as a variation of breast augmentation.
Methods:
The data collected represents a retrospective chart review of consecutive abdominoplasty procedures performed at a single outpatient facility by the senior surgeon (WGS) over a 15-year period (1989-2004). Two groups were compared: patients who underwent abdominoplasty without breast surgery, and those that had abdominoplasty with breast surgery. The second group was subdivided by the various types of breast procedures noted above.
Minor complications assessed included seromas, hematomas, infections, and small (<5cm) wound breakdowns. Major complications evaluated included large (>5cm) flap necrosis, need for blood transfusion, deep vein thrombosis, pulmonary embolus, myocardial infarction, and death. Additional data compiled included age, gender, tobacco use, body mass index (BMI), past medical history, ASA physical status level and operative times.
Case Numbers:
Of the 415 abdominoplasty procedures, 264 (Group 1) did not include simultaneous breast surgery. One hundred and fifty-one procedures (Group 2) involved simultaneous breast surgery, representing thirty-six percent of the total. Group 2 was further subdivided into those who had breast augmentation surgery (Group 2A, # Cases = 50), those who had breast reduction surgery (Group 2B, # Cases = 31), those who had mastopexy surgery (Group 2C, # Cases = 28), and those who had simultaneous mastopexy and breast augmentation surgery (Group 2D, # Cases = 42). Removal and replacement of implants and capsulectomy/capsulotomy procedures were included in the augmentation group (Group 2A).
Summary of Results:
There were no major complications including flap necrosis (open wound > 5cm), blood transfusions, deep vein thrombosis, pulmonary embolus, myocardial infarction, or death. No patients required a hospitalization.
No statistically significant differences in complications were noted between Group1 and Group 2 (Chi square 0.0045, p<0.95, NS). Furthermore, when subdivided by type of breast surgery, no statistically significant differences were noted between subgroups: Group 1 versus 2A (Chi square 0.96, p<0.05, NS), Group 1 versus 2B (Chi square 0.032, p< 0.9, NS), Group 1 versus 2C (Chi square 0.003, p<0.975, NS), Group 1 versus 2D (Chi Square 0.83, p< 0.5, NS).
Conclusion:
The results of this retrospective review indicate that aesthetic breast surgery combined with abdominoplasty did not significantly increase the number of major or minor complications. Furthermore, no significant difference in complications was noted when comparing the various breast surgery subgroups.