Abdominoplasty Practice Patterns: An American Society of Plastic Surgeons Member Survey—How Much Has Changed Over 20 Years?

Background: In 2006, Matarasso et al. published an American Society of Plastic Surgeons member survey detailing abdominoplasty practice patterns. The purpose of the current study is to explore how surgical techniques, ancillary procedures, practice patterns, and surgical outcomes have changed in the interim. Methods: A 38-question descriptive survey was designed based on the 2006 study. Selected modifications were incorporated to investigate new techniques and trends. Surveys were distributed anonymously to a random cohort of 1765 American Society of Plastic Surgeons members. Results were compared with the 2006 survey and to current practice recommendations in the plastic surgery literature. Results: A total of 256 responses (14.5% response rate) were received. Full abdominoplasty with rectus plication and umbilical transposition was the most performed abdominal contouring technique in both studies. Use of abdominal flap liposuction as an adjunct to abdominoplasty decreased from 54% to 48.6% ( P = 0.191). Use of ultrasound-assisted liposuction also decreased from 13% to 6.4% ( P < 0.001), whereas that of power-assisted liposuction increased from 14% to 50.7% ( P < 0.001). Progressive tension sutures and tranexamic acid were novel practice tools incorporated by 49.8% and 38.3% of respondents, respectively; 39.6% reported using barbed suture for rectus plication. Drain use decreased from 98% in 2006 to 82.5% ( P < 0.001). Willingness to perform concomitant breast surgery was universally high for both surveys. Current respondents were, however, less likely to perform intraabdominal or facial operations compared with those in 2006. Conclusion: Nuanced changes in the abdominoplasty operation have occurred over the past 20 years, as have adjuncts used to improve results and limit morbidity.