Feasibility, Safety and Efficacy of Outpatient Lipoabdominoplasty with Sedation, TAP Block, and Tumescent Anesthesia

Introduction: Postoperative pain after abdominoplasty can reduce patient satisfaction, delay mobility, and increase complications like deep vein thrombosis (DVT). Multimodal analgesia, including transversus abdominis plane (TAP) blocks, improves pain control, reduces opioid use, improving recovery, minimizing DVT risks, and promoting early ambulation and recovery. Objective: This article examines the safety, effectiveness, and practical aspects of abdominoplasty under sedation and TAP block as an alternative to general anesthesia, detailing the anesthetic protocol and patient outcomes. Materials and methods: This prospective, single-center case series encompassed all consecutive lipoabdominoplasty patients from December 2020 to June 2025. Epidemiology, procedures, medications, patient-reported outcomes, satisfaction, and complications were collected via standardized questionnaires, including BodyQ, Patient and Observer Scar Assessment Scale (POSAS) and International Pain Outcome (IPO) questionnaire. Results: Forty patients (mean age 37 ± 11) underwent lipoabdominoplasty under conscious sedation and TAP-block; 45% also underwent breast surgery. During the first 24 postoperative hours, 31% of patients experienced at least one episode of severe pain, lasting a cumulative average of 2.4 hours. 90% reported minimal/no nausea. No antiemetics were required; 25% received one opioid dose. Analgesia satisfaction was 90%. Median discharge time was 2:42 h (interquartile range [IQR] 2:00–3:16). Appearance satisfaction was 100% (IQR 81–100%). Conclusion: Lipoabdominoplasty with sedation, TAP block, and tumescent anesthesia can be safely performed in the outpatient setting, with minimal to no nausea, low to moderate pain, and great patient satisfaction. The evidence supports revisiting postoperative care pathways to ensure prudent utilization of hospital assets, like minimizing unnecessary inpatient observation, without compromising outcomes. Level of Evidence: IV.