Abdominal dermolipectomies: Early postoperative complications and long-term unfavorable results

A retrospective study was done on a population of 258 women who had undergo ne surgery for abdominal dermolipectomy between January of 1991 and May of 1996. The postoperative complications and flaws seen at longterm follow-up are discussed. The surgical techniques used, with Or without lipoaspiration , were the infraumbilical plasty and full plasties with horizontal or inver ted T scars. Six types of postoperative complications were noted: hemorrhag e in 1.2 percent, lymphorrhea in 10.9 percent, infection in 7 percent, skin necrosis in 6.6 percent, secondary dehiscence of the scar in 2.3 percent, and thromboembolic accidents in 1.2 percent. No significant difference was found in the rate of necrosis development between patients who did and did not undergo lipoaspiration. However, a statistically significant difference was seen in the rate of skin necrosis between the T-type plasty (35.5 perc ent) and the other two procedures (1.43 percent for infraumbilical plasties and 4.60 percent for full plasties with horizontal scar). With regard to t he flaws found at long-term follow-up, the rate of above-scar fat folds and /or dog-ears was 27.9 percent, and the rate of defective scars was 26 perce nt. No significant difference was found with regard to the rate of flaws. T he rate of all secondary surgical procedures was 29.1 percent, but performa nce of secondary procedures depended on the willingness of the patient and on the surgeon's judgment. Abdominoplasty procedures involve a high risk of early complications. The rate of skin necrosis is clearly augmented in cas es of T-type plasty. The need for secondary surgical correction is frequent , and the patient should be reminded of this possibility during preoperativ e consultation.