Complication and Risk Assessment in Postbariatric Abdominoplasty Patients

Background: Abdominoplasty is the most common body contouring procedure after bariatric surgery. Complications in postbariatric patients differ due to altered body composition and comorbidities. This study investigated postoperative complications and risk factors, particularly the effects of liposuction volume and psychiatric comorbidities. Methods: A retrospective cross-sectional study was conducted on patients who underwent abdominoplasty between 2018 and 2023. Variables analyzed included age, sex, body mass index (BMI), surgical resection weight, liposuction volume, rectus diastasis repair, psychiatric comorbidities, smoking status, and postoperative complications. Results: Among 124 patients (67 females, 57 males; mean age 38.99 years), those with a history of bariatric surgery ( n = 62) had a higher prevalence of psychiatric comorbidities and rectus diastasis repair. Nonbariatric patients ( n = 62) had a greater resection weight, increased liposuction volume, and a higher incidence of seroma. Seroma risk was significantly associated with liposuction volume ( p = 0.002), BMI ( p < 0.05), and smoking ( p < 0.05). Psychiatric comorbidities correlated with prolonged wound healing (defined as >3 weeks to complete closure or requiring extended dressings) and higher seroma rates ( p = 0.027). Conclusion: Complication rates in body contouring surgeries after bariatric surgery are influenced by body mass index, comorbidities, and surgical techniques. Despite higher complication rates, seroma incidence was lower in postbariatric patients, likely due to reduced liposuction volume and altered subcutaneous tissue composition. Comprehensive preoperative assessments are essential for optimizing outcomes.