Combined liposuction/tummy tuck offers best of both procedures

Low complication rates with techniques to minimize surgical trauma, reports study in PRS Global Open

2013-08-20

(Press-News.org) Philadelphia, Pa. (August 20, 2013) – A combined technique of liposuction and tummy tuck—designed to reduce surgical trauma—provides excellent patient outcomes with a low complication rate, reports a study in Plastic and Reconstructive Surgery-Global Open®, the official open-access medical journal of the American Society of Plastic Surgeons (ASPS).

ASPS Member Surgeon Dr. Eric Swanson, a plastic surgeon in private practice in Leawood, Kan., presents an in-depth report on his experience with a combined technique of liposuction and abdominoplasty in a large series of patients over five years. He writes, "Liposuction and abdominoplasty, individually and in combination, may be performed safely with appropriate measures to reduce complications by minimizing tissue trauma."

Detailed Analysis of Combined 'Lipoabdominoplasty' In the combined "lipoabdominoplasty" procedure, patients initially underwent ultrasonic liposuction to remove excess fat from the abdomen and flanks (love handles). Liposuction was followed by abdominoplasty—or "tummy tuck"—to eliminate excess abdominal tissue and loose skin. Outcomes after lipoabdominoplasty in 150 patients were compared to liposuction alone in 384 patients and abdominoplasty alone in 17 patients.

Notably, no liposuction patients developed seromas--collections of fluid under the skin--which is attributed to limited ultrasound to reduce tissue trauma. There was a low (five percent) rate of seromas after abdominoplasty. Dr. Swanson writes that seromas have led some plastic surgeons to leave behind some abdominal fat and connective tissue during abdominoplasty in an effort to reduce this risk. He believes that preserving this excess tissue is unnecessary and compromises the cosmetic result.

Less-Traumatic Technique Limits Complications The study demonstrates that by using shorter periods of ultrasound and eliminating the traditional use of electrodissection during surgery, the risk of seromas may be minimized while at the same time achieving excellent cosmetic outcomes. By first injecting the tissues with fluid containing epinephrine, blood loss is reduced, making cautery dissection unnecessary.

Dr. Swanson also describes a modified form of general anesthesia – total intravenous anesthesia without muscle paralysis – to reduce the risk of blood clots in the legs. Only one patient in his series developed this complication and was successfully treated. He writes that by adopting safe preventive measures, surgeons may reduce the risk of this serious complication without the need for blood-thinning medication. Patients also recover more quickly after surgery, averaging only 51 minutes in the recovery room, and experience less nausea.

Taking advantage of the PRS GO's open-access format, the article includes videos in which Dr. Swanson demonstrates his lipoabdominoplasty technique. He illustrates a technique of deep tissue anchoring to keep the tummy tuck scar low and hidden within the bikini line.

Liposuction and abdominoplasty are common cosmetic plastic surgery procedures that are often performed together. However, few well-designed studies have investigated the outcomes of the combined procedures. This new study includes systematically collected data in a large series of consecutive patients undergoing a consistent technique performed by a single surgeon.

In a previous study, published in Plastic and Reconstructive Surgery last year, Dr. Swanson reported high patient satisfaction rates and improved self-esteem in patients undergoing liposuction and/or abdominoplasty—especially the combined technique. The new results show that, with attention to some basic measures to reduce risk, excellent cosmetic results are achieved with a low complication rate. "Lipoabdominoplasty may be performed safely, so that patients may benefit from both modalities," Dr. Swanson concludes.

### Plastic and Reconstructive Surgery—Global Open® is published by Lippincott Williams & Wilkins, part of Wolters Kluwer Health.

About PRS Global Open Plastic and Reconstructive Surgery-Global Open® (PRS GO) is a companion journal to the American Society of Plastic Surgeons' flagship publication, Plastic and Reconstructive Surgery. PRS GO is an open access, rigorously peer-reviewed, international journal focusing on global plastic and reconstructive surgery. PRS GO educates and supports plastic surgeons globally to provide the highest quality patient care and maintain professional and ethical standards through education, research, and advocacy.

About ASPS The American Society of Plastic Surgeons (ASPS) is the world's largest organization of board-certified plastic surgeons. Representing more than 7,000 Member Surgeons, the Society is recognized as a leading authority and information source on aesthetic and reconstructive plastic surgery. ASPS comprises more than 94 percent of all board-certified plastic surgeons in the United States. Founded in 1931, the Society represents physicians certified by The American Board of Plastic Surgery or The Royal College of Physicians and Surgeons of Canada. ASPS advances quality care to plastic surgery patients by encouraging high standards of training, ethics, physician practice and research in plastic surgery. You can learn more and visit the American Society of Plastic Surgeons at http://www.plasticsurgery.org or http://www.facebook.com/PlasticSurgeryASPS and http://www.twitter.com/ASPS_news.

About Wolters Kluwer Health Wolters Kluwer Health is a leading global provider of information, business intelligence and point-of-care solutions for the healthcare industry. Serving more than 150 countries and territories worldwide, Wolters Kluwer Health's customers include professionals, institutions and students in medicine, nursing, allied health and pharmacy. Major brands include Health Language®, Lexicomp®, Lippincott Williams & Wilkins, Medicom®, Medknow, Ovid®, Pharmacy OneSource®, ProVation® Medical, and UpToDate®.

Wolters Kluwer Health is part of Wolters Kluwer, a market-leading global information services company. Wolters Kluwer had 2012 annual revenues of €3.6 billion ($4.6 billion), employs approximately 19,000 people worldwide, and maintains operations in over 40 countries across Europe, North America, Asia Pacific, and Latin America. Follow our official Twitter handle: @WKHealth.

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Combined liposuction/tummy tuck offers best of both procedures

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