Safety of Outpatient Drainless Extended Abdominoplasty: An Analysis of 164 Consecutive Cases

Background Extended abdominoplasty combines abdominoplasty, flank excision, and circumferential waist liposuction to address circumferential waist dermatolipodystrophy. Circumferential excisional body contouring procedures have traditionally been performed in an inpatient setting because of longer operative times. Objectives The aim of the present study was to describe the authors’ current approach to drainless extended abdominoplasty and to evaluate safety outcomes for patients undergoing this procedure in an outpatient setting. Methods The authors performed a retrospective chart review of all patients who underwent outpatient extended abdominoplasty in their practice. Patient demographics, procedural characteristics, and postoperative outcomes were evaluated. Results A total of 164 patients (86.0% female) underwent extended abdominoplasty from December 2013 to February 2025. Average age was 42 years (range, 17-76 years), and average BMI was 28.4 kg/m2 (range, 21.1-39.2 kg/m2). Seventy-one (43.3%) patients had significant weight loss from bariatric surgery. Forty-three (26.2%) patients underwent a combined procedure with the extended abdominoplasty, the most common being breast surgery (37 patients, 86.0%). The average length of surgery for extended abdominoplasty was 210 min (range, 120-368 min). Overall, 26 patients (15.9%) experienced a postoperative complication, including 25 surgery-site complications managed on an outpatient basis and 1 systemic complication (Ogilvie syndrome) requiring hospital admission. There were no demographic or operative variables associated with postoperative complications. However, there was a statistically significant association between greater weight loss (P = .045) and higher excised tissue weight (P = .040) with postoperative complications. Conclusions Drainless extended abdominoplasty can be safely performed in an outpatient setting. Patient selection and perioperative care pathways are conducive to consistent results.