The Addition of Partial or Circumferential Liposuction to Abdominoplasty Is Not Associated With a Higher Risk of Skin Necrosis.

BACKGROUND Combining abdominoplasty with liposuction is a common practice for optimal patient aesthetic outcomes. In the past, several practitioners have argued against liposuction due to the potential for vascular insufficiency, especially with central liposuction. Despite these concerns for flap damage with resultant necrosis, the incidence of this complication has not been comprehensively investigated. OBJECTIVE The authors therefore examined the incidence of necrotic complications, including skin and fat necrosis, as well as partial/total flap loss, in patients undergoing abdominoplasty alone (AA) or abdominoplasty with partial or circumferential liposuction (APCL). METHODS Literature searches were performed in PubMed/Medline and Embase with no query limits. For the systematic review, data from the studies were extracted into a form including primary author, publication year, study design, number of AA and APCL patients, abdominal zone(s) treated with liposuction, average lipoaspirate volume, follow-up time, necrotic complications, and revision procedures. A meta-analysis was separately performed for 13 studies that included patients undergoing both AA and APCL. RESULTS The overall rate of necrotic complications was lower in the APCL group (0.39%) compared to the abdominoplasty alone group (1.01%). The incidence of necrotic complications was low for all patients, with a pooled partial flap loss rate of 0.24% and a pooled skin necrosis rate of 0.23%. The forest plots revealed that patients who underwent APCL do not face a higher risk of skin necrosis or revision compared to those who underwent abdominoplasty alone. CONCLUSION Performing abdominoplasty with partial or circumferential liposuction is a safe combined procedural approach and can confer added benefits of improved patient satisfaction and aesthetic outcomes.