Seroma formation following abdominoplasty: a retrospective clinical review following three different techniques

This retrospective study was aimed to assess the clinical role of simultaneous liposuction, extent of skin undermining, and progressive tension suture on seroma formation following abdominoplasty. A chart review of 121 patients was done and divided in three groups. Group A included patients with abdominoplasty and liposuction of flanks. Group B included with abdominoplasty, liposuction of flanks, and progressive tension sutures. Group C had abdominoplasty, limited supraumbilical undermining, progressive tension sutures, liposuction of the abdominal wall and flanks. Seroma formation was based on the presence of fluctuant swelling in hypogastric area. Group A included 53 patients, had 1,096 g tissue excised (range 98–5,812) with an average liposuction of 854 cc with incidence of 26% seroma. Group B included 24 patients, with an average removal of 997 g tissue (range 75–2,440) with an average liposuction of 700 cc and an incidence of 7.7% seroma. Group C included 44 patients, had on average 803 g tissue excised (range 76–2,092) with an average liposuction of 816 and 610 cc from flanks and abdominal wall, respectively. There was 0% seroma formation. Statistical analysis was performed using ANOVA test and showed no statistical difference between tissue excised (p = 0.18) and liposuction performed (p = 0.25) on the hips and flanks. Blood loss (p < 0.001) and first 24 h drainage (p < 0.001) were significantly reduced in patients with progressive tension sutures and limited supraumbilical undermining. There was a significant reduction in seroma formation (p < 0.001) when progressive tension sutures were used with limited supraumbilical undermining and analyzed using Fischer exact test.