Background: In light of the scarce literature published regarding seroma formation (SF) following abdominoplasty when performed with or without liposuction, the objective of this study was to determine whether abdominoplasty performed in conjunction with flank liposuction confers an increased risk for SF compared to abdominoplasty alone.

Methods: This was a retrospective cohort study of 200 patients who underwent abdominoplasty with or without liposuction from 2004 to 2007. Medical records were reviewed to collect data regarding patient demographics, length of drain use, operative technique, seroma formation, and other complications. Seroma formation was determined by physical exam one week following closed-suction drain removal. Logistic regression analysis was used to determine independent predictors of SF. Results were considered significant at p < 0.05.

Results: In the study, 125 patients underwent abdominoplasty with flank liposuction and 75 patients underwent abdominoplasty alone. The incidence of SF was 16.0% in the abdominoplasty alone group and 31.4% in the abdominoplasty with liposuction group (p<0.05). The mean age was 43.1 ± 10.2 years and the mean BMI was 27.3 ± 5.4 kg/m2. Increasing BMI (OR 1.1, 95% CI 1.02-1.17) and liposuction of the flanks (OR 3.3, 95% CI 1.37-7.97) were independent and significant predictors of seroma formation in abdominoplasty patients.

Conclusions: Patients should be counseled regarding an increased risk of seroma formation following abdominoplasty when combined with liposuction of the flanks. In addition, patients who are overweight are at an increased risk for developing a postoperative seroma compared to patients with normal body mass indices.