81. The Impact of Body Mass Index on Surgical and Aesthetic Outcomes in Cosmetic Abdominoplasty

PURPOSE: Obesity is widely recognized to increase the risk of post-operative complications in plastic surgery. Current literature regarding the impact of body mass index (BMI) and the associated risk in body contouring remains under question. This study aimed to elucidate the risk of abdominoplasty in overweight and obese patients. METHODS: A retrospective review of patients undergoing cosmetic abdominoplasty from 2015-2021 by a single surgeon was conducted. Cosmetic abdominoplasty was defined as an abdominal contouring procedure, frequently including liposuction or rectus abdominis plication, that was not covered by insurance. Demographics, surgical site occurrences (SSO), post-operative cosmetic complaints, such as scarring, asymmetry and loose skin, and reoperations were compared. SSOs were defined as infection, delayed healing, dehiscence, seroma, and fat necrosis. Univariate and multivariate logistic regression were used to assess the risk of BMI on clinical outcomes. RESULTS: One-hundred and thirteen patients underwent cosmetic abdominoplasty. Forty patients (35.4%) were normal weight (BMI ≥18.5 kg/m2-<25kg/m2), 43 (38.1%) were overweight (BMI ≥25 kg/m2-<30 kg/m2), and 30 (26.6%) were obese (BMI ≥30 kg/m2). The study population was predominantly female (93.0%), and Caucasian (57.5%). Liposuction volume was significantly different (P=<0.001) between groups, with the largest volume removed in obese patients, but diastasis plication was not (P=0.490). Twenty-four of 33 instances of SSO were due to delayed healing (21%). After logistic regression modelling and controlling for confounding variables, there was no increased risk of SSO, cosmetic complaints, or reoperation in overweight or obese patients compared to normal weight patients. CONCLUSION: Despite apprehension towards performing body contouring in obese patients, our study supports the safety and efficacy of abdominoplasty in populations with higher BMIs. We identified no significant increased risk of SSO, cosmetic complaints, or reoperations in obese patients compared to non-obese or non-overweight patients. This study can help improve pre-operative counseling and patient selection for those seeking abdominoplasty.