Background: Lipoabdominoplasty is an established technique, however outcomes for high lipoaspirate volumes in large series are lacking. We present the UK experience of high-volume, drainless lipoabdominoplasty using progressive deep tension sutures.
Methods: 286 consecutive patients at a single centre underwent drainless lipoabdominoplasty with a lipoaspirate volume of 500 ml or greater between 2017 and 2023. Surgery was performed under total intravenous anaesthesia with SAFELipo©, MicroAire® and a superwet technique. Abdominoplasty was commenced via a low convex abdominal incision with multilayer rectus plication, and abdominal closure undertaken with progressive tension sutures. Logistic regression was used to determine the relationship between lipoaspirate volume and four primary outcomes - all complications, delayed healing, seroma, and need for revision.
Results: The mean lipoaspirate volume was 2392.4 ml (500-5900), and abdominal tissue resection weight 1392.0 g (346-3802). One third of patients had local complications - minor irregularities (14.0%), abdominal scar problems (12.9%), umbilical shape/scar (4.5%), localised infection (4.2%) and delayed healing (3.8%). One (0.3%) had a small area of localised necrosis successfully managed by further tissue advancement. There was one abdominal haematoma, and two systemic complications- venous thromboembolism (0.3%) and drug-induced hepatitis. Seroma rate was 3.1%. 16.0% of patients required revision under general anaesthesia, and 6.6% under local anaesthetic. There was no significant relationship between the lipoaspirate volume and any of the four primary outcome measures.
Conclusions: High-volume liposuction can safely be performed simultaneously with abdominoplasty. Our complication rates are equivalent to, or lower than other published data on lipoabdominoplasy, challenging current concepts in body sculpting.
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