Risk of Concomitant Abdominoplasty and Breast Surgery versus Isolated Procedures: A Systematic Review and Meta-analysis.

BACKGROUND: Concomitant abdominoplasty and breast surgery has gained popularity among women seeking comprehensive esthetic rejuvenation. However, concerns remain regarding whether combining procedures increases perioperative risk compared with performing them in isolation.
PURPOSE: Compare complication rates following concomitant abdominoplasty and breast surgery versus isolated procedures.
MATERIALS AND METHODS: A systematic search of PubMed, EMBASE, Web of Science, and Cochrane Library was conducted. Eligible studies included patients undergoing abdominoplasty, breast surgery, or both, with direct comparison of complication rates. Risk of bias was assessed using ROBINS-I, and certainty of evidence was graded with GRADE. Random-effects meta-analysis was performed to calculate pooled odds ratios with 95% confidence intervals.
RESULTS: Eight studies encompassing 138,020 patients were included. Of these, 9,422 underwent concomitant procedures, 11,700 underwent abdominoplasty alone, and 106,898 underwent isolated breast surgery. Pooled analysis showed no statistically significant difference in overall complication rates between concomitant and isolated procedures (OR 1.11; 95% CI 0.63-1.96; I2 = 97.9%). Subgroup analysis demonstrated a nonsignificant reduction in complications compared with abdominoplasty alone (OR 0.66; 95% CI 0.37-1.16), but a significantly increased risk compared with breast surgery alone (OR 2.71; 95% CI 1.74-4.23). Single-institution studies yielded consistent results with, while database analyses were highly heterogeneous. Certainty of evidence ranged from moderate to very low.
CONCLUSION: Concomitant abdominoplasty and breast surgery carries a complication profile comparable to abdominoplasty alone but elevated relative to breast surgery alone. These findings suggest that combined procedures are generally safe in carefully selected patients.
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