High-Volume Drainless Lipoabdominoplasty with Progressive Tension Sutures: UK Experience

Lipoabdominoplasty is an established technique, but outcomes of high lipoaspirate volumes in large series are lacking. The authors present the UK experience of high-volume, drainless lipoabdominoplasty using progressive deep tension sutures.

A total of 286 consecutive patients at a single center underwent drainless lipoabdominoplasty with a lipoaspirate volume of 500 mL or greater between 2017 and 2023. Surgery was performed under total intravenous anesthesia with SAFELipo, MicroAire, and a superwet technique. Abdominoplasty was commenced through a low convex abdominal incision with multilayer rectus plication, and abdominal closure was undertaken with progressive tension sutures. Logistic regression was used to determine the relationship between lipoaspirate volume and 4 primary outcomes: all complications, delayed healing, seroma, and need for revision.

The mean lipoaspirate volume was 2392.4 mL (range, 500 to 5900 mL), and the abdominal tissue resection weight was 1392.0 g (range, 346 to 3802 g). One-third of patients had local complications (minor irregularities, 14.0%; abdominal scar problems, 12.9%; umbilical shape or scar, 4.5%; localized infection, 4.2%; and delayed healing, 3.8%). One patient (0.3%) had a small area of localized necrosis that was managed successfully by further tissue advancement. There was 1 abdominal hematoma and 2 systemic complications (venous thromboembolism, 0.3%; and drug-induced hepatitis, 0.3%). The seroma rate was 3.1%. A total of 16.0% of patients required revision under general anesthesia, and 6.6% under a local anesthetic. There was no significant relationship between the lipoaspirate volume and any of the 4 primary outcome measures.

High-volume liposuction can be performed safely simultaneously with abdominoplasty. The authors' complication rates are equivalent to or lower than other published data on lipoabdominoplasty, challenging current concepts in body sculpting.

Risk, III.