Background:  Concerns over the safety of combining extensive liposuction with abdominoplasty in a one-stage lipoabdominoplasty procedure persist.  This study reports a comparison of the perfusion related complication rates between lipoabdominoplasty (LA) and traditional abdominoplasty (TA) among "high risk" patients, those more susceptible to complications secondary to a smoking history or previous supraumbilical abdominal scar. 

Methods: Chart Review of 149 patients from the Yale University Cosmetic Clinic who had undergone either lipoabdominoplasty or traditional abdominoplasty between 2004 and 2008 were reviewed. Patients were classified as "high risk" if they were an active smoker or had a previous abdominal surgery resulting in a significant supraumbilical abdominal scar.  Specific vascularity-related complications were compared between the techniques.

Results: Patients undergoing lipoabdominoplasty had a perfusion related complication rate of 4.88% compared to 8.96% in those undergoing traditional abdominoplasty (p = 0.35). Among high-risk patients (24 smokers and 16 patients with significant supraumbilical scars), there was no statistically significant difference for perfusion related complications including skin necrosis, wound infection or wound dehiscence.  The need for surgical revision in patients undergoing lipoabdominoplasty was 10.98%, while 20.90% of patients undergoing traditional abdominoplasty needed revisional surgery (p=0.113).

Conclusion: Lipoabdominoplasty is not associated with a statistically significant increase in perfusion related complication rates as compared to traditional abdominoplasty, despite the fact that it involves potential trauma to the vascularity of the elevated abdominoplasty flap. This holds true even in patients who are at increased risk for perfusion-related complications secondary to a history of active smoking or a previous supraumbilical scar.