Obesity as a Risk Factor in Cosmetic Abdominal Body Contouring: A Systematic Review and Meta-Analysis.
Level 3 - non-randomized controlled study
Systematic review and meta-analysis of non-randomized observational studies
PubMed 37644187 · doi:10.1007/s00266-023-03602-w
What was done
A PRISMA-guided systematic review was conducted across PubMed, Embase, Scopus, and Cochrane databases for studies evaluating cosmetic abdominoplasty or panniculectomy (defined as non-massive weight loss populations, with <50% massive weight loss patients). Obesity was defined as BMI ≥ 30 kg/m². Postoperative outcomes were evaluated via pooled analysis and meta-analysis comparing patients with obesity to non-obese controls and across obesity classes.
What was found
From 3,088 initial records, 16 studies met inclusion criteria and 9 were analyzed quantitatively. Obesity was associated with higher odds of seromas (OR 1.45, 95% CI 1.06–1.98, p = 0.02), hematomas (OR 2.21, 95% CI 1.07–4.57, p = 0.03), and total surgical site occurrences (OR 1.99, 95% CI 1.30–3.04, p = 0.0016). No significant differences were found for other complications. Subgroup analysis by obesity class showed no significant increase in the odds of seromas or wound dehiscence with higher classes of obesity.
Why it matters
This review demonstrates that while obesity increases the risk of local surgical site complications in cosmetic abdominal body contouring, risk does not appear to escalate linearly with higher obesity classes, supporting individualized patient assessment over rigid BMI cutoffs.
Limits
The total number of patients is not reported in the abstract. Only 9 of 16 eligible studies had data suitable for meta-analysis. Included studies were non-randomized observational series susceptible to selection bias, surgical technique variability, and unmeasured confounders. Long-term aesthetic and patient-reported outcomes were not reported in the abstract.
Cited by
- supports Patients who are significantly overweight have a higher risk of surgical healing complications, including abscesses, wound necrosis, and infection.