Archive | May 2012

The Facts About Abdominoplasty Combination Procedures

Abdominoplasty is a cosmetic operation that is...

A recent report discusses the apparent safety of combining abdominoplasty (tummy tuck) with hysterectomy.  The abstract is available on page 30 of the PDF here.

The authors retrospectively studied 65 cases of combined abdominoplasty and hysterectomy (the number of abdominal vs. vaginal hysterectomies is not mentioned, which is an important distinction).

The authors note a 32% overall complication rate, but state there were “no major complications…” they conclude that the combination procedure is safe and effective.  But is this accurate?

It is not a randomized study, though performing such a study is impractical.

Commentary by Dr. Sherrell Aston correctly points out that a transfusion is not a minor complication.

A combination procedure that results in blood loss sufficient to warrant blood replacement is a significant operation.  The specific indications for transfusion are not given, and it is possible more liberal criteria were used in the earlier years over the study’s range (1995-2011).  Even so, it is rare to need a blood transfusion in cosmetic surgery.  Most prudent surgeons would stage procedures that might result in the need for transfusion, such as substantial skin reduction surgeries following massive weight loss.

Below I present a sampling of various studies that have examined the combination of abdominoplasty with other intra-abdominal procedures over the last few decades.   Rather than going through all the details here, I will summarize them  below.  Click here for each full reference.

The data shows that abdominoplasty combined with hysterectomy or other major procedure can be safe and effective.  However, complication rates may be higher than with either procedure alone.  It is difficult to be certain because most studies are retrospective.

Complication rates for combination procedures approach 30%.  The risk of major complications such as transfusion or pulmonary embolism may have decreased in recent years, perhaps due to better preventive methods and tighter indications for transfusion.  Obesity is one of the main risk factors for complications.

Patients interested in undergoing a combination procedure should carefully consider their options as well as the experience of their surgeon(s).

Combination procedures may offer advantages of lower cost and shorter overall recovery time.  The chance of complications may vary between surgeons of differing experience, and patients who are obese or have significant medical problems can have a higher risk of perioperative problems.

Advertisements