Is Plastic Surgery Combined with Obstetrical Procedures Safe?

Aesthetic Plast Surg. 2019 Oct;43(5):1396-1399. doi: 10.1007/s00266-019-01448-9. Epub 2019 Jul 24.

Abstract

In the existing reports on combined procedures of abdominoplasty with Cesarean section or natural delivery, a high incidence of complications and poor aesthetic results are reported. We conducted a survey with the participation of 61 plastic surgeons who performed this procedure in 808 patients, with an average of 13.24 procedures per surgeon. In 783 procedures (96.9% of the cases), the combination was with Cesarean section and 25 procedures (3.13% of cases) were combined with vaginal delivery. The plastic surgery procedures were as follows: 242 abdominoplasty procedures (29.95%), 210 abdominoplasty plus liposuction procedures (25.99%), 18 mini abdominoplasty procedures (2.22%), 121 mini abdominoplasty and liposuction procedures (14.97%), and 217 liposuction procedures (26.85%). The following complications were reported: seroma in 255 cases (31.57%), thrombosis in 212 (26.23%), infection in 170 (21.03%), skin necrosis in 127 (15.71%), and hematoma in 42 (5.19%). There were three deaths due to thrombosis (0.4%). There were redundancy skin abdominal wall defects in 336 (41.66%) cases, unaesthetic scars in 291 (36.11%), abdominal wall defects in 134 (16.58%), unpleasant contours in 22 (2.72%), and rotational folds in 22 (2.72%). Fifty-five (90.16%) surgeons decided to stop delivering babies with these practices. The combination of abdominoplasty with Cesarean section or natural delivery has a high incidence of complications and poor aesthetic results; therefore, we make a strong recommendation to avoid this practice before the patient reaches sixth month postpartum.Level of Evidence IV This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Keywords: Abdominoplasty; Body contouring; Cesarean section; Combined procedures with abdominoplasty; Obstetric patients; Postpartum.

MeSH terms

  • Abdominoplasty / adverse effects
  • Abdominoplasty / methods*
  • Cesarean Section / adverse effects
  • Cesarean Section / methods*
  • Combined Modality Therapy
  • Female
  • Humans
  • Mexico
  • Patient Safety
  • Postoperative Complications / epidemiology
  • Postoperative Complications / pathology*
  • Postoperative Complications / physiopathology
  • Pregnancy
  • Risk Assessment
  • Safety Management
  • Societies, Medical
  • Surgery, Plastic / adverse effects
  • Surgery, Plastic / methods*
  • Surgical Wound / surgery
  • Surveys and Questionnaires*