Anesthetic Management and Perioperative Predictors of Outcomes in Combined Body Contouring Procedures

Brazilian Butt Lift (BBL), liposuction, and abdominoplasty are increasingly being performed in combination to enhance esthetic results and reduce recovery time. However, this approach may lead to prolonged surgical times, complex anesthesia management, and an increased risk of potential complications. This study aims to evaluate the relationship between intraoperative variables and postoperative complications in patients undergoing combined body contouring surgery.

A total of 1120 patients who underwent esthetic surgery between 2020 and 2025 were included in this retrospective cohort study. Patients were divided into two groups: Group 1 (n = 550) underwent BBL, liposuction, and abdominoplasty; Group 2 (n = 570) underwent only BBL and liposuction. Demographic data, intraoperative parameters, laboratory values, and postoperative complications were analyzed. Multivariate logistic regression and ROC analyses were performed to identify factors predicting complications.

In Group 1, the duration of surgery, amount of crystalloid fluid administered, volume of aspirate removed by liposuction, amount of fat injected, and urine output were significantly higher (p < 0.001). The total complication rate was 0.8%, with postoperative complications developing in only 9 patients. Three of these patients (33.3%) had a history of bariatric surgery. In the logistic regression analysis, prolonged surgical duration (OR = 2.12) and a history of surgery (OR = 1.87) were associated with the development of complications; however, neither reached statistical significance (p > 0.05). In the ROC analysis (multivariate), the model's discriminatory power was high (AUC = 0.94).

Combined esthetic surgeries appear to be safe when performed by an experienced surgical-anesthesia team with close intraoperative monitoring. Surgical duration and previous surgical history may be associated with complications; however, larger prospective studies are needed to confirm these findings.

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 .