Outcomes and Indications in Revision Abdominoplasty: A Systematic Review.

[BACKGROUND] Revision abdominoplasty is an increasingly relevant subset of body contouring surgery, yet it remains underrepresented in the literature. Indications range from early postoperative complications to aesthetic dissatisfaction and complications arising from medical tourism. This systematic review aims to characterize the spectrum of revision abdominoplasty by identifying common indications, surgical techniques, and outcomes.

[METHODS] A systematic review was conducted according to PRISMA guidelines, querying PubMed, Scopus, and Embase for studies reporting outcomes of revision abdominoplasty. Inclusion criteria encompassed original studies and case reports explicitly describing revision procedures, their indications, and postoperative results. Data were thematically synthesized and stratified into key domains: indication for revision, surgical approach, and complications following revision.

[RESULTS] Sixteen studies (n = 262) met inclusion criteria, including 8 retrospective cohort studies, 2 small case series, and 6 case reports. Indications for revision were grouped into 3 major themes: (1) postoperative complications following index abdominoplasty (eg, seroma, necrosis, hematoma), (2) aesthetic dissatisfaction or contour irregularities, and (3) complications resulting from abdominoplasty performed abroad. Surgical approaches ranged from Z-plasty and tissue expansion to capsulectomy and full staged reconstructions. Postrevision complications included infection (20%), seroma (20%), necrosis (20%), hematoma (13%), and dehiscence (13%). Outcomes were generally favorable, with high satisfaction and resolution of prior deformities in most cases.

[CONCLUSIONS] Revision abdominoplasty is a diverse and complex surgical domain that warrants greater academic attention. This review offers the first structured synthesis of indications and outcomes, highlighting the need for standardized reporting, long-term data, and validated patient-reported outcome measures to guide surgical planning and patient counseling.