Increased outpatient procedures, liposuction, and heparin use

Abdominoplasty continues to be a safe and effective procedure, with more cases being performed on an outpatient basis and the use of concomitant liposuction increasing, according to a new 16-year analysis in the January issue of Plastic and reconstructive surgery®, the official medical journal of the American Society of Plastic Surgeons (ASPS). The magazine is published in the Lippincott portfolio by Wolters Kluwer.

Leveraging quality improvement data provided by US board-certified plastic surgeons, our study provides new insight into the evolution of the abdominoplasty technique.”

Michael J. Stein, MD, MAS, FRCSC, FACS, Lead Author Lenox Hill Hospital, New York, New York

Changes in tummy tuck techniques and outcomes from 2005 to 2021.

Abdominoplasty – sometimes called a “tummy tuck” – is a cosmetic surgical procedure to improve the appearance of the abdomen. In 2022, ASPS member surgeons performed nearly 162,000 abdominoplasty procedures, according to ASPS statistics.

To assess the evolution of practices and surgical techniques, Dr. Stein and colleagues analyzed data from the American Board of Plastic Surgery (ABPS) continuous certification process. In this process, plastic surgeons provide information on specific “follow-up procedures” as evidence of continuous improvement in clinical practice.

Researchers analyzed data on 8,990 abdominoplasty cases submitted by 390 ABPS-certified plastic surgeons between 2005 and 2021. To assess trends over time, cases were divided into early (2005-14) and recent (2015-21) cohorts.

Over the study period, the rate of outpatient abdominoplasty, without an overnight hospital stay, increased from 77% to 81%; and increased use of heparin to prevent complications related to blood clots. Patients treated in recent years are more likely to undergo multiple surgical procedures, especially liposuction to reduce fat in the abdominal flap.

“Abdominoplasty remains a safe and reliable procedure”

Other technical changes include reduced use of wide tissue undermining, vertical abdominal plication, and postoperative surgical drains—although all of these techniques continue to be used in most abdominoplasty cases. The researchers noted that while the observed changes were statistically significant, they were “best evaluated as positive or negative trends in practice between cohorts rather than clinically meaningful changes in practice.”

“Abdominoplasty remained a safe and reliable procedure during the study period, with a slight but statistically significant reduction in adverse events in the recent cohort,” concluded Dr. Stein and coauthors. “Careful preoperative assessment of patients should identify risk factors that increase the risk of complications.”

Senior author and former ASPS president Dr. Alan Mataraso of Manhattan Eye, Ear and Throat Hospital has contributed to similar reviews using data from ABPS continuous certification of other “follow-up” procedures—the most recent report included a report on trends in cosmetic augmentation on the chest. Fellow authors include Drs. Arun Ghosain and Peter Rubin.

Dr. Mataraso commented, “Although not without potential sources of bias, the use of data from the ABPS continuous certification—with mandatory reporting of a large number of common procedures by board-certified plastic surgeons—provides unique insight into trends in surgical practice and indicators to inform further efforts to improve safety and quality.”

source:

Journal reference:

Stein, MJ, and others. (2024). Clinical practice patterns in abdominoplasty: a 16-year analysis of continuous American Board of Plastic Surgery certification data. Plastic and reconstructive surgery. doi.org/10.1097/PRS.0000000000010500.

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