Five and a Half Years' Experience with the Avelar Lipoabdominoplasty Procedure: Analysis of Complication Rates

Abstract

Introduction: The Avelar lipoabdominoplasty procedure has been described in the literature as a safe procedure with fewer complications than traditional abdominoplasty because of limited upper abdominal dissection, which spares the superior neurovascular bundles along with the lymphatics. In the author's published article in 2008, 80 patient charts were evaluated retrospectively, and the complication rates were compared with other studies presented in the literature. The purpose of this study is to compare the complication rates of the first 2 years to the subsequent 31/2 years since the procedure was adopted. The Avelar mini-lipoabdominoplasty procedures were also reviewed, and the complication rates were compared with those of the full Avelar procedures. Materials and Methods: A retrospective review was performed of records of patients who underwent a full or mini-Avelar lipoadominoplasty procedure from July 1, 2007 to December 31, 2010. Results: A total of 89 patient charts were reviewed. There were 73 full lipoabdominoplasty and 16 mini-lipoabdominoplasty procedures performed by the author. The mean age of the patients was 42 years; 46% had general anesthesia and 54% had conscious sedation. In the 89 patients who underwent both types of procedures, there was 1 case of skin necrosis (1.1% incidence compared with a 3.7% incidence the first 2 years), 4 seromas (4.5% incidence compared with 12.5% incidence in the original study), and no deep venous thromboses or hematomas. For the full lipoabdominoplasty procedures, the skin necrosis rate was 1.4% compared with 3.9% in the 2008 study, and the seroma rate was 5.5% compared with 13.0%. There were 9 small skin dehiscences (10% incidence), and there were 4 postoperative infections (4.5% incidence). The mini-lipoabdominoplasties had none of these complications. Conclusions: The complication rates have decreased in the subsequent 31/2 years compared with the first 2 years. This is probably due to increased surgeon experience, not operating on smokers in the second part of the study, and using the Erchonia EML (Erchonia Medical Inc, Mesa, Ariz) on all patients pre- and postoperatively. The rates were lower than those reported for traditional abdominoplasties. There were none of the above complications for the mini-abdominoplasties using the Avelar technique.