Abdominoplasty continues to be a safe and effective procedure, with more cases being performed on an outpatient basis and increased use of concurrent liposuction, 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 submitted 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” techniques and outcomes from 2005 to 2021
A tummy tuck – sometimes called a “tummy tuck” – is a cosmetic surgery 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 practice patterns and surgical techniques, Dr. Stein and colleagues analyzed data from the American Board of Plastic Surgery (ABPS) continuing certification process. In this process, plastic surgeons submit information on specific “detection procedures” as evidence of continued improvement in clinical practice.
Researchers analyzed data on 8,990 abdominoplasty cases performed 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) cases. cohorts.
The study period showed an increased rate of outpatient abdominoplasty, without an overnight stay in the hospital, from 77% to 81%. and increased use of heparin to prevent complications related to blood clots. Patients treated in more recent years were more likely to undergo multiple surgeries, particularly liposuction to reduce fat in the abdominal tissue flap.
“Abdominoplasty remains a safe and reliable procedure”
Other technical changes included reduced use of wide tissue undermining, vertical abdominoplasty, and postoperative surgical drains—although all of these techniques continued to be used in most abdominoplasty cases. The researchers note that while the observed changes are statistically significant, “they are better evaluated as positive or negative practice trends between cohorts, rather than clinically meaningful changes in practice.”
“Abdominoplasty remains a safe and reliable procedure during the study period, with a slight but statistically significant reduction in adverse events in the recent cohort,” conclude Dr. Stein and colleagues. “Careful preoperative assessment of patients should identify risk factors that increase the risk of complications.”
Senior author and past ASPS President Dr. Alan Matarasso of Manhattan Eye, Ear and Throat Hospital has contributed to similar reviews using ABPS continuous certification data for other “tracer” procedures – most recently, including a report on trends in breast augmentation. Co-authors include Drs. Arun Gosain and Peter Rubin.
Dr. Matarasso comments: “Although not without potential sources of bias, the use of ABPS continuous certification data – with mandatory reporting of a large number of common procedures by board-certified plastic surgeons – provides unique insights into trends in surgical practice and benchmarks to inform further safety improvement efforts and quality”.
Source:
Journal Reference:
Stein, MJ, et al. (2024). Standards of clinical practice in abdominoplasty: 16-year analysis of continuous certification data from the American Board of Plastic Surgery. Plastic and Reconstructive Surgery. doi.org/10.1097/PRS.00000000000010500.
