High-Volume Drainless Lipoabdominoplasty with Progressive Tension Sutures: UK Experience.

[BACKGROUND] Lipoabdominoplasty is an established technique, but outcomes of high lipoaspirate volumes in large series are lacking. The authors present the UK experience of high-volume, drainless lipoabdominoplasty using progressive deep tension sutures.

[METHODS] A total of 286 consecutive patients at a single center underwent drainless lipoabdominoplasty with a lipoaspirate volume of 500 mL or greater between 2017 and 2023. Surgery was performed under total intravenous anesthesia with SAFELipo, MicroAire, and a superwet technique. Abdominoplasty was commenced through a low convex abdominal incision with multilayer rectus plication, and abdominal closure was undertaken with progressive tension sutures. Logistic regression was used to determine the relationship between lipoaspirate volume and 4 primary outcomes: all complications, delayed healing, seroma, and need for revision.

[RESULTS] The mean lipoaspirate volume was 2392.4 mL (range, 500 to 5900 mL), and the abdominal tissue resection weight was 1392.0 g (range, 346 to 3802 g). One-third of patients had local complications (minor irregularities, 14.0%; abdominal scar problems, 12.9%; umbilical shape or scar, 4.5%; localized infection, 4.2%; and delayed healing, 3.8%). One patient (0.3%) had a small area of localized necrosis that was managed successfully by further tissue advancement. There was 1 abdominal hematoma and 2 systemic complications (venous thromboembolism, 0.3%; and drug-induced hepatitis, 0.3%). The seroma rate was 3.1%. A total of 16.0% of patients required revision under general anesthesia, and 6.6% under a local anesthetic. There was no significant relationship between the lipoaspirate volume and any of the 4 primary outcome measures.

[CONCLUSIONS] High-volume liposuction can be performed safely simultaneously with abdominoplasty. The authors' complication rates are equivalent to or lower than other published data on lipoabdominoplasty, challenging current concepts in body sculpting.

[CLINICAL QUESTION/LEVEL OF EVIDENCE] Risk, III.