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Safety of Combined Versus Isolated Cosmetic Breast Surgery and Abdominoplasty: Insights from a Multi-institutional
Samuel Knoedler1, Michael Alfertshofer2, Dany Y Matar1
1Division of Plastic Surgery, Department of Surgery, Brigham and Women's Hospital, Harvard Medical School, 75 Francis Street, Boston, MA, 02115, USA.
Introduction:
Abdominoplasty and breast surgery are popular cosmetic procedures, often performed as stand-alone or combined procedures. However, the safety of combining these surgeries remains poorly understood.
Methods:
We analyzed data from the ACS-NSQIP database spanning 2008-2021, focusing on patients who underwent isolated cosmetic breast surgery, isolated cosmetic abdominoplasty, or the combination of both. We evaluated four primary outcomes: general complications (reoperation, readmission, mortality), surgical complications, medical complications, and overall complications (general + surgical + medical). Further analysis considered the specific type of cosmetic breast surgery.
Results:
A total of 7865 female patients were identified, of whom 20.5% underwent isolated abdominoplasty, 65.3% cosmetic breast surgery, and 14.2% combined abdominoplasty with concurrent cosmetic breast surgery. Combined surgery was associated with a significantly higher risk of reoperations (OR 2.07; p = 0.04) compared to abdominoplasty alone. However, there was no significant difference in overall complications (OR 1.17; p = 0.40), surgical complications (OR 0.72; p = 0.26), or medical complications (OR 0.97; p = 0.91) between these two groups. Comparing combined to isolated cosmetic breast surgery, there was a higher risk of overall complications (OR 1.70; p = 0.04) and medical complications (OR 5.30; p < 0.0001) but no significant difference in general complications (OR 1.40; p = 0.33) or surgical complications (OR 0.85; p = 0.73).
Conclusion:
Combining breast surgery with abdominoplasty increases the risk of reoperations but does not elevate the risk of surgical or medical complications. However, patients seeking combined surgeries are more likely to experience adverse events than those seeking isolated cosmetic breast surgery.
Level Of Evidence Iii:
This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .
