New Study Suggests Older Age Is Not an Impediment to Abdominoplasty

Abdominoplasty is becoming an increasing popular cosmetic surgery procedure among older adults. What’s more, cosmetic surgery appears to be an exception to the rule that older age equals more complications, reports James Zins, MD, Chairman of the Department of Plastic Surgery at Cleveland Clinic.

Recent research reviewing large patient databases have concluded that age is an independent risk factor for complications after abdominoplasty. Not necessarily, says Dr. Zins, who collaborated on the retrospective study with lead author and plastic & reconstructive surgery resident Rafael A. Couto, MD. “These review studies, by design, considered only major complications and complications occurring over a short time period after surgery,” Dr. Zins says. “Therefore, we set out to evaluate the safety of abdominoplasty in older versus younger patient populations and determine major, minor, local and systemic complication rates over both the short and the long term.”

A look at the study design

The study population was comprised of 129 patients (43 in the older group, median age 65.0 years, and 86 in the younger age group, median age 41.5 years). The study design was a retrospective review of patients who underwent abdominoplasty (defined as resection of abdominal skin and subcutaneous soft tissue, with undermining up to the xiphoid process, and including transposition of the umbilicus) at Cleveland Clinic between January 1, 2010 and December 31, 2015.

Most of the patients had American Society of Anesthesiology (ASA) scores of 1, and older patients were more likely to have higher ASA scores than younger patients (1 and 2 vs 1, respectively). Older patients also tended to have more comorbidities than younger patients. The most common reasons for surgery in both groups were unacceptable cosmetic appearance, weight loss and obesity. The median length of follow up was four months in the younger group and five months in the older group, with ranges of one to 24 months and one to 30 months, respectively.

The results showed that when patients were well screened for comorbidities such as significant heart or pulmonary disease, previous medical issues and illnesses, older individuals undergoing abdominoplasty had no greater risk of complications than younger patients. “There were no statistically significant differences in any types of complications between the two groups,” says Dr. Zins, adding, “We actually had found a similar result in a previous series of older versus younger patients who underwent face lift. Abdominoplasty is a higher-risk surgery than face lift, so we wanted to know if we could control for complications in that population as well, and it turns out we can.”

A growing patient population

Seniors are the fastest growing sector of the US population, and many of them are interested in having cosmetic surgery procedures. In fact, 40 percent of all surgeries and 7.5 percent of cosmetic procedures are performed in patients over the age of 65.

“We’re seeing large numbers of older patients who are fit and healthy and want to look as good as they feel,” says Dr. Zins. “Now, due to the elective nature of cosmetic procedures and the ability to prescreen out patients who are not healthy, we know that abdominoplasty, facelift and other cosmetic surgeries can, indeed, often be performed safely.”

Results of the study were published in the Aesthetic Surgery Journal.