Outpatient Circumferential Abdominoplasty in the Non Post-Bariatric Surgery Patient

Introduction

     Circumferential abdominoplasty is a body contouring procedure that provides 360° improvement in body shape and contour.  However, it has traditionally been associated with a number of drawbacks.  Our aim is to quantify and compare these factors when performed in the outpatient setting.  Furthermore, investigation of non-bariatric patient satisfaction with circumferential abdominoplasty is perhaps the more important factor in determining integration of the procedure for this particular patient population into a practice.

Methods

     A retrospective review of 59 consecutive patients who underwent circumferential abdominoplasty, performed by a single surgeon in an outpatient setting from 2006 to 2013, was investigated.  Patient demographics, comorbidities & operative details were recorded.  Major & minor complications, corresponding interventions & postoperative details were followed.  Patients were invited to participate in a satisfaction survey at a follow up appointment.

Results

     Of the 59 patients undergoing circumferential abdominoplasty, 89.8% were female with an average age of 44.  The average BMI was 27.  Only one patient was a smoker.  Just over half of the patients, 50.8%, experienced a complication, the majority of which were minor.  A small percentage, 13.6%, required a revision.  Increased amounts of tissue and lipoaspirate removed correlated with increased complications, p=0.000 and p=0.016 respectively.  Patients experiencing a complication were more likely to undergo a revision, p=0.029, as were patients with increased BMI, p=0.030, and those having additional procedures performed, p=0.010.  The patient survey had a 33.9% response rate.  100% of patients stated that their expectations were met, with an average overall satisfaction rating of 9.4 on a 1 – 10 scale.  45% of patients stated that they experienced problems, but 90% of patients stated that they would undergo the procedure again.

Conclusions

     Circumferential abdominoplasty can be safely performed in the outpatient setting in the non post-bariatric patient.  There is a high associated complication rate of 50.8%, however the majority of complications are minor, and all are non-life threatening.  More importantly, patient survey data demonstrates that patients acknowledge complications at approximately the same rate as medical reports, 45% v. 50.8%.  Still, the patients report high rates of satisfaction despite those complications.  Patient satisfaction is arguably the most important determination of a successful cosmetic operation.  Therefore, integration of outpatient circumferential abdominoplasty is a reasonable option for non post-bariatric patients seeking cosmetic body contouring.