Adding Liposuction Helps Prevent Common Complication after Tummy Tuck
New Technique May Lower Risk of Seromas after Abdominoplasty

Arlington Heights, Ill. - For patients undergoing plastic surgery to flatten the abdomen, a technique incorporating liposuction can help to avoid postoperative problems with seroma, according to a study in the October issue of Plastic and Reconstructive Surgery®, the official medical journal of the American Society of Plastic Surgeons (ASPS).

The new technique helps avoid the "troublesome complication" of seroma without the need to place a drain after the abdominoplasty procedure. The lead author of the study is ASPS Member Surgeon Dr. Carl W. Lentz III of Florida State University, Daytona Beach.

Liposuction Technique Reduces Seromas while Avoiding Drains

Seromas are collections of wound fluid that can develop after of surgery. They are a common problem after abdominoplasty, sometimes called "tummy tuck"-a popular plastic surgery procedure done to flatten and contour the abdomen by removing excess fat and skin.

Previous studies reported widely varying rates of seroma after abdominoplasty: from one to fifty percent. Seromas commonly develop a few weeks after abdominoplasty. To prevent this fluid buildup, the surgeon may place a drain at the end of the procedure, which remains in place for a week or longer. The drain can cause discomfort and a risk of infection for the patient, without eliminating the risk of seroma.

Dr. Lentz and colleagues developed a new technique using liposuction to prevent seroma without the need for a drain. They used the technique in 113 patients undergoing abdominoplasty over a six-year period. Many of the patients underwent other plastic surgery procedures at the same time (such as breast augmentation or reduction or liposuction of other areas).

The technique included an extended incision, allowing surgeons to use gentle liposuction to remove fat under the skin. This approach avoided damage to the blood and lymph vessels while improving blood flow to the abdominal skin above the incision. The incision was snugly closed using progressive tension sutures, which minimized the "dead space" underneath where fluid could collect.

Ten patients developed seromas after abdominoplasty: a rate of 8.8 percent. Most of the seromas were small, requiring only simple treatment in the surgeon's office. The remaining four patients had larger seromas requiring placement of a drain.

Other problems were uncommon, including collections of blood (hematomas) in three patients. There were a few cases of infection and other complications, generally minor.

Despite modern surgical techniques and drain placement, seroma is still a common problem after abdominoplasty. Dr. Lentz and colleagues believe their liposuction technique can help not only control this risk, but also improve the abdominal wall and waist contour. They conclude, "Rates of seroma formation in this study are similar if not better than those reported in the literature, and the lack of drains decreases sources of infection and irritation to the patient."

Plastic and Reconstructive Surgery® is published by Lippincott Williams & Wilkins, part of Wolters Kluwer Health.