Tension suture technique combined with lidocain-adrenalin-saline-infiltration decreases complications in abdominoplasty.

BACKGROUNDS AND AIMS: Due to growing interest into body contouring has abdominoplasty become one of the most common aesthetic operations. New techniques have appeared to reduce the relatively high incidence of complications in abdominplasty. One technique is the tension suture technique, which can be combined with lidocain-adrenalin-saline-infiltration. Our aim was to analyse the results of this combined technique. MATERIAL AND METHODS: This retrospective study consisted of 95 women operated on in a private hospital by one senior plastic surgeon between years 2004 and 2009. Sixty patients had other operations in addition to abdominoplasty: 49 liposuctions, six breast reductions or mastopexies, three umbilical hernioplasties, one brachioplasty, one partial excision of labias, and one blepharoplasty. RESULTS AND CONCLUSIONS: The operative time was 82 minutes ranging from 45 to 173 minutes. Peroperative bleeding was a mean of 196 ml in abdominoplasty only and 254 ml when combined with additional operation. Patients did not have any major complications and the total incidence of minor--not clinically significant--complications was 12.6%. Obesity, smoking, comorbidities, previous operations on belly area or additional operations did not affect the complication rates. Our study supports the view that the tension suture technique combined with lidocain-adrenalin-saline-infiltration decrease the formation of seroma and wound complications in abdominoplasty. Lidocain-adrenalin-saline-infiltration also fastens and eases the operation without increasing the risk of bleeding in experienced hands.

The outcome of reduction mammaplasty is affected more by psychosocial factors than by changes in breast dimensions.

BACKGROUND AND AIMS: Several randomised studies have proved the effects of breast reduction surgery. However, search for predictive factors has not been successful. Therefore we decided to analyse breast dimension changes and to see whether these, or patient characteristics or individual psychosocial factors have an effect on the outcome. MATERIAL AND METHODS: Twenty-nine patients were assessed at baseline and at six months follow-up. Outcome measures used were two health-related quality of life questionnaires, a breast-associated symptoms questionnaire, a pain-rating questionnaire, and a mood questionnaire. Detailed breast dimensions were recorded. Forward stepwise linear regression was applied to detect possible associations between outcome measure changes and breast dimensions or patient-related factors. RESULTS: Preoperatively anxious patients had more improvement in the quality of life index scores, but less improvement in the mental health scores when compared to patients not anxious. Patients with physically demanding work had more improvement in the quality of life index scores and a trend to less improvement in the mental health scores when compared to patients with physically less stressful work. Patients with no overweight had a trend to better improvement in self-esteem. CONCLUSIONS: The outcome of reduction mammaplasty is affected more by psychosocial factors than by changes in breast dimensions.