Minimising complications in abdominoplasty: An approach based on the root cause analysis and focused preventive steps

Abstract

Significant complications still occur after abdominoplasty, the rate varies widely in different series. This variation suggests that there is a lot of scope for improvement. This paper reviews the various complications and also the technical improvements reported in the last 20 years. The root cause of each complication is analysed and preventive steps are suggested based on the literature and the author′s own personal series with very low complication rates. Proper case selection, risk stratified prophylaxis of thromboembolism, initial synchronous liposuction, flap elevation at the Scarpa fascia level, discontinuous incremental flap dissection, vascular preservation and obliteration of the sub-flap space by multiple sutures emerge as the strongest preventive factors. It is proposed that most of the complications of abdominoplasty are preventable and that it is possible to greatly enhance the aesthetic and safety profile of this surgery.

Keywords

• Abdominoplasty
• complications
• diastasis recti
• haematoma
• lipoabdominoplasty
• necrosis
• seroma
• venous thromboembolism
• ventral hernia
• wound dehiscence