Outcomes of traditional cosmetic abdominoplasty in a community setting: a retrospective analysis of 1008 patients.

BACKGROUND: Abdominoplasty is one of the most commonly performed cosmetic operative procedures. Few large studies have examined outcomes of cosmetic abdominoplasty in a community setting. The authors explored postoperative outcome and the preoperative and intraoperative factors that may contribute to these complications. METHODS: A retrospective review of consecutive patients undergoing abdominoplasty over an 11-year period was performed. Baseline patient demographics, intraoperative technique, and postoperative outcomes were recorded. Preoperative and intraoperative characteristics were analyzed to determine characteristics that predispose patients to complications and undesirable outcomes. RESULTS: The 1008 study patients underwent either a full or modified abdominoplasty with a total complication rate of 32.6 percent. The most common complication was seroma (15.4 percent). Liposuction of the abdominal flap was performed in 469 patients (46.5 percent) and liposuction of the flanks was performed in 555 patients (55.1 percent). Chi-square analysis followed by logistic regression revealed that liposuction of the flanks and abdomen was independently associated with seroma formation in addition to major and minor complications (p < 0.05). CONCLUSIONS: Seroma formation following abdominoplasty is the most common complication. Concomitant liposuction of the flanks and abdomen with the addition of aggressive undermining leads to higher seroma rates. This association is likely multifactorial and may be secondary to increased resorptive demands placed on the abdominal lymphatics in the setting of greater dead space and larger fluid shifts as a result of liposuction. To reduce seroma rates, surgeons should avoid aggressive liposuction and undermining, particularly in high-risk patients.

Fibromatosis of the cervical region following laminectomy: a case report and literature review.

STUDY DESIGN: A case report and a discussion of recently published data. OBJECTIVE: To highlight the occurrence of postoperative fibromatosis arising in the cervical spine. SUMMARY OF BACKGROUND DATA: Fibromatosis is a benign, locally invasive fibroblastic proliferation that can cause compressive effects on adjacent structures. Although the precise etiology of fibromatosis remains unclear, numerous studies have investigated the role of pluripotent mesenchymal stem cells in ß-catenin-regulated tumorigenesis. At present, aggressive fibromatosis is managed with wide local excision. Postoperative radiation therapy is indicated for incomplete excision. METHODS: A 48-year-old woman presented with a 2-year history of enlarging paracervical fibromatosis after undergoing extensive cervicothoracic instrumentation for excision of an extradural schwannoma. The patient underwent wide local excision of the neck mass, with right trapezius myocutaneous flap reconstruction of the subsequent defect. RESULTS: Histologically, the lesion was shown to be fibromatosis. Six months postoperatively, the patient was doing well with no recurrence. CONCLUSION: Fibromatosis is an important diagnosis to consider when evaluating locally aggressive spinal lesions at sites of prior operative repair. Molecular and genetic studies pertaining to the role of mesenchymal stem cells and ß-catenin in the pathogenesis of aggressive fibromatosis tumors could lead to possible worthwhile treatment strategies in the future.