Is It Safe to Combine Excisional Procedures with Liposuction in Body Contouring Surgery?

BACKGROUND: Excisional procedures, including abdominoplasty, brachioplasty, thighplasty, and body lift are often combined with liposuction with the goals of minimizing cost and hospital stays while maximizing aesthetic results. The aim of this study is to evaluate postoperative complications in patients undergoing excisional surgery with or without liposuction. Risk factors for this type of combined body contouring surgery are also evaluated. Methods: The electronic medical records of 413 patients undergoing body contouring surgery at UT Southwestern Medical Center were retrospectively reviewed. Three groups of patients were compared: liposuction only, excision only, and combined liposuction and excision surgeries. Some patients also received additional intra-abdominal, gynecologic, and breast procedures. Patient variables analyzed included age; body mass index (BMI); American Society of Anesthesiologists risk score (ASA score); Caprini score; operative time; co-morbidities (diabetes, hypertension, cardiovascular diseases, pulmonary diseases, and renal diseases); smoking status; prophylactic antibody use, and recent major surgery. RESULTS: No statistically significant differences in complication rates were found when comparing combined excision and liposuction surgeries to excision alone. Operative time was a significant risk factor for developing wound problems and overall complications. There was a trend for males and patients with higher BMI, older age (>45), and co-morbidities toward developing postoperative complications. CONCLUSIONS: Combining excisional body contouring procedures with liposuction does not increase overall complication rates in this cohort of patients. Plastic surgeons should balance the number of combined procedures with estimated operative time in order to maximize patient safety.