Knoedler Samuel, Alfertshofer Michael, Matar Dany Y, Sofo Giuseppe, Hundeshagen Gabriel, Didzun Oliver, Bigdeli Amir K, Friedrich Sarah, Schenck Thilo, Kneser Ulrich, Orgill Dennis P, Knoedler Leonard, Panayi Adriana C
Division of Plastic Surgery, Department of Surgery, Brigham and Women's Hospital, Harvard Medical School, 75 Francis Street, Boston, MA, 02115, USA.
Department of Plastic Surgery and Hand Surgery, Technical University Munich, Munich, Germany.
Aesthetic Plast Surg. 2025 Apr 10. doi: 10.1007/s00266-025-04800-4.
Abdominoplasty and breast surgery are popular cosmetic procedures, often performed as stand-alone or combined procedures. However, the safety of combining these surgeries remains poorly understood.
We analyzed data from the ACS-NSQIP database spanning 2008-2021, focusing on patients who underwent isolated cosmetic breast surgery, isolated cosmetic abdominoplasty, or the combination of both. We evaluated four primary outcomes: general complications (reoperation, readmission, mortality), surgical complications, medical complications, and overall complications (general + surgical + medical). Further analysis considered the specific type of cosmetic breast surgery.
A total of 7865 female patients were identified, of whom 20.5% underwent isolated abdominoplasty, 65.3% cosmetic breast surgery, and 14.2% combined abdominoplasty with concurrent cosmetic breast surgery. Combined surgery was associated with a significantly higher risk of reoperations (OR 2.07; p = 0.04) compared to abdominoplasty alone. However, there was no significant difference in overall complications (OR 1.17; p = 0.40), surgical complications (OR 0.72; p = 0.26), or medical complications (OR 0.97; p = 0.91) between these two groups. Comparing combined to isolated cosmetic breast surgery, there was a higher risk of overall complications (OR 1.70; p = 0.04) and medical complications (OR 5.30; p < 0.0001) but no significant difference in general complications (OR 1.40; p = 0.33) or surgical complications (OR 0.85; p = 0.73).
Combining breast surgery with abdominoplasty increases the risk of reoperations but does not elevate the risk of surgical or medical complications. However, patients seeking combined surgeries are more likely to experience adverse events than those seeking isolated cosmetic breast surgery.
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腹壁成形术和乳房手术是常见的美容手术，通常单独进行或联合进行。然而，联合这些手术的安全性仍知之甚少。
我们分析了2008年至2021年美国外科医师学会国家外科质量改进计划（ACS-NSQIP）数据库中的数据，重点关注接受单纯美容性乳房手术、单纯美容性腹壁成形术或两者联合手术的患者。我们评估了四个主要结局：一般并发症（再次手术、再次入院、死亡）、手术并发症、医疗并发症和总体并发症（一般+手术+医疗）。进一步分析考虑了美容性乳房手术的具体类型。
共确定了7865名女性患者，其中20.5%接受了单纯腹壁成形术，65.3%接受了美容性乳房手术，14.2%接受了腹壁成形术并同期进行美容性乳房手术。与单纯腹壁成形术相比，联合手术再次手术的风险显著更高（OR 2.07；p = 0.04）。然而，两组在总体并发症（OR 1.17；p = 0.40）、手术并发症（OR 0.72；p = 0.26）或医疗并发症（OR 0.97；p = 0.91）方面没有显著差异。与单纯美容性乳房手术相比，联合手术总体并发症（OR 1.70；p = 0.04）和医疗并发症（OR 5.30；p < 0.0001）的风险更高，但在一般并发症（OR 1.40；p = 0.33）或手术并发症（OR 0.85；p = 0.73）方面没有显著差异。
乳房手术与腹壁成形术联合增加了再次手术的风险，但并未增加手术或医疗并发症的风险。然而，寻求联合手术的患者比寻求单纯美容性乳房手术的患者更有可能经历不良事件。
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