A systematic review of outcomes of abdominoplasty.

Abdominoplasty is a well-established operation to remove abdominal tissue excess. The patients' benefits and risks of this surgical treatment are, however, incompletely studied. The aim of this study was to evaluate the quality of evidence of benefits and risks for patients having abdominoplasty from massive weight loss or childbirth. Outcome measures were quality-of-life, respiratory function, back pain, and complication rates. PubMed, Cochrane Database of Systematic Reviews, CRD, CINDAHL, AMED, PsycInfo and different Health technology Assessment organizations (SBU, Kunnskapssenteret, Sundhetsstyrelsen) were searched for articles published until October 2011. Inclusion criteria were studies written in English or Scandinavian language including at least 30 patients with a control group and a case series of at least 100 patients. Review articles and case studies were excluded. The scientific level of evidence was evaluated using the GRADE-system. One small controlled study on abdominoplasty was found indicating a positive effect on quality-of-life. No controlled studies evaluating the other outcomes respiratory function and back pain were found. One prospective study reported minor complications averaging to 25%. Fourteen retrospective studies reported the same pattern. The major complication venous thromboembolism was found in 2%-8% in three series. It is concluded that the quality of evidence of positive health effects for patients having abdominoplasty is very low concerning all studied outcomes.