Morbidity in combined-procedure associating abdominoplasty and breast surgery: A systematic review

Combined aesthetic procedures are an increasing procedure and demands of the patients. The authors have assembled concrete arguments detailing the risks of combined-surgery associating abdominoplasty and mammoplasty relative to abdominoplasty alone. The purpose of this study was to compare abdominoplasty alone versus abdominoplasty combined with breast surgery in terms of short-term complications, in support of surgical choices. Through application of the PRISMA criteria, we have realized a systematic review of the literature from 1969 to April 2015 in English and French languages by searching in MEDLINE®, PubMed central, Embase and Cochrane Library databases. The levels of evidence for each article were evaluated. Statistical analysis of the results was carried out through association parameters including statistical tests and Odds ratios were calculated for each complication when data was available. We included 32 observational studies that met the inclusion criteria but only four with usable data. We highlighted a combined Odds ratio of respectively 5.35 and 14.71 for major complications in these studies for combined-surgery compared with abdominoplasty alone. The results of this systematic review appears in favor of an increase in major complications related to abdominoplasty combined with breast surgery compared to abdominoplasty alone but the level of evidence of included studies is low or moderate. Prospective cohort comparative studies are necessary to provide strong evidence. However, we recommend to avoid this procedure in massive weight loss patients or patients with thromboembolism history. La chirurgie plastique combinée est de plus en plus demandée et recherchée par les patients. C’est pourquoi les auteurs ont recherché des arguments concrets détaillant les bénéfices et risques de la chirurgie combinée associant abdominoplastie et chirurgie mammaire versus abdominoplastie seule. Le propos de cette étude est de comparer abdominoplastie seule et abdominoplastie avec chirurgie mammaire en termes de complications à court terme afin d’orienter le geste chirurgical. En accord avec les critères PRISMA, une revue systématique de la littérature a été réalisée entre 1969 et avril 2015 en anglais et en français, à partir des bases de données MEDLINE®, PubMed central, Embase et Cochrane Library. Les niveaux de preuve de chaque article ont été évalués. Au travers d’une analyse statistique, l’association avec différents paramètres a été obtenue en calculan