Clinical Practice Patterns and Evidence-Based Medicine in Abdominoplasty: 16-Year Analysis of Continuous Certification Tracer Data from the American Board of Plastic Surgery

This study evaluates trends in practice patterns for abdominoplasty based on a 16-year review of tracer data collected by the American Board of Plastic Surgery (ABPS) as part of the Continuous Certification (CC) process.In order to facilitate comparison of an equal number of patients over time, tracer data from 2005 to 2021 was split into an "early cohort (EC)" from 2005-2014 and a "recent cohort (RC)" from 2015-2021. Fisher's exact tests and two-sample t-tests compared patient demographics, surgical techniques, and complication rates.Data from 8990 abdominoplasties (4740 EC, 4250 RC) was analyzed. Recent cohort abdominoplasties report a lower rate of complications (19% compared to 22% for EC, p<0.001) and a lower rate of revisionary surgery (8% compared to 10% for EC, p<0.001). This has occurred despite the increased use of abdominal flap liposuction (25% vs 18% for EC, p<0.001). Wide undermining, (81% vs 75%, p<0.001), vertical plication (89% vs 86%, p<0.001), and the use of surgical drains (93% vs 89%, p<0.001) have all been reduced to a significant degree in the RC. Abdominoplasty surgery is increasingly performed in an outpatient setting, with increased use of chemoprophylaxis for thrombosis prevention.Analysis of this ABPS tracer data highlights important trends in clinical practice over the last 16 years. Abdominoplasty continues to be a safe and effective procedure with similar complication and revision rates over the 16-year cohort.