Predictors of Complications in Abdominoplasty: A Multivariate Analysis of 150 Consecutive Cases
Agostino Bruno1, Riccardo Foti2
1Private practice, Santa Maria di Leuca Clinic, Via Tiberina, 178, 00188, Rome, RM, Italy.
Background:
Abdominoplasty has evolved from a purely aesthetic operation into a refined reconstructive procedure integrating both functional and contouring principles. Despite significant technical progress and standardized safety protocols, postoperative complications remain relatively common. Identifying independent predictors of these events is essential to improve outcomes and reduce morbidity.
Methods:
A retrospective analysis was conducted on 150 consecutive abdominoplasties performed between 2015 and 2023 by a single surgical team. Demographic data, comorbidities, and operative variables were recorded, including procedure type, Scarpa's fascia management, drain use, and operative time. Complications were categorized as major or minor. Univariate and multivariate logistic regression analyses were performed to identify independent predictors of postoperative complications.
Results:
The overall complication rate was 27.3%, including both minor and major events. The most frequent complications were seroma (14.6%), wound dehiscence (6.6%), and partial skin necrosis (4.6%). The reoperation rate was 6%. Multivariate analysis identified high body mass index (BMI ≥30 kg/m2) and active smoking as independent predictors of complications (p < 0.05). Preservation of Scarpa's fascia was independently associated with a significantly lower risk of seroma and wound morbidity (p < 0.05).
Conclusions:
High BMI and active smoking are the dominant independent predictors of postoperative complications following abdominoplasty, whereas preservation of Scarpa's fascia confers a protective effect by maintaining lymphatic continuity and reducing dead space. These findings emphasize the importance of careful patient selection, smoking cessation, and adherence to fascial preservation techniques to optimize safety and outcomes.
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 .
