Goals/Purpose: There is limited data in the literature regarding the general incidence of complete secondary abdominal contour procedures or specific recommendations for surgical management of these patients.
Methods/Technique: We performed a retrospective chart review of 562 patients who underwent abdominal contouring procedures (liposuction, modified or full abdominoplasty) by a single surgeon from January 2004 until October 2012.
Results/Complications: 73 of 562 (13.0%) patients underwent secondary abdominal contouring procedures. Charts of 46 of 73 patients were available and examined in greater detail. 35 patients underwent secondary liposuction, while 11 had secondary full abdominoplasty. Secondary procedures occurred an average of 4.98 years after the primary procedure (range 6 months-15 years). Patient underwent secondary liposuction (n=35) an average of 3.16 years after their initial procedure, significantly sooner than patients who underwent secondary abdominoplasty (n=11) 8.35 years after their initial procedure (p=0.002). In patients who underwent secondary liposuction, primary liposuction was associated with a significantly greater average volume of lipoaspirate during the secondary procedure than was primary abdominoplasty of any kind (1885ml vs. 1483ml). The weight of the secondary abdominoplasty flap resection was not significantly different regardless of the primary procedure (primary liposuction/abdominoplasty, 399g/388g). Only patients with BMI < 25 kg/m2 (n=26) underwent secondary abdominoplasty while all patients with BMI >/= 25 kg/m2, (n=20) underwent liposuction. There were no major systemic complications.
Conclusion: True secondary abdominal contouring procedures represent 13.0% of all abdominal contouring procedures. We identified the primary operations most likely to incur secondary procedures, their indications and provide guidelines for treating these patients with specific recommendations for management of 5 common scenarios.
Table. Common scenarios of primary and secondary abdominal contouring surgery
Pre/post photographs of 62 yo F s/p primary liposuction who underwent secondary full abdominoplasty with liposuction
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Pre/post photographs 39 yo F s/p mini-abdominoplasty with umbilical float who underwent secondary full abdominoplasty
