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Study: Combining Hysterectomy with Cosmetic Surgery for ‘Hanging Abdomen’ is Safe

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HysterectomyA hysterectomy or the surgical removal of a woman’s uterus is recommended to treat problems associated with menstrual periods, pelvic pain, fibroids, tumors and other related conditions. One of the issues that patients who have undergone the surgery face is hanging abdominal skin. According to a recent study published in Plastic and Reconstructive Surgery® it is safe for women to also have a cosmetic procedure to remove hanging abdominal fat and skin at the same surgery without increasing the risk of complications.

Panniculectomy is a type of abdominoplasty performed to remove excess fat and skin from the area and does not involve muscle tightening. This procedure can considerably reduce the appearance of a protruding abdomen

Using a national surgical database, the researchers identified more than 25,000 women who underwent hysterectomy between 2005 and 2012. In this group, 174 underwent panniculectomy at the same operation. Thirty-day complication rates were compared for those who did a combination procedure and hysterectomy alone.

Those who underwent a combination procedure were more likely to be obese, and to have diabetes and a history of heart or lung disease. The surgical time for the combo was about four hours, compared to two hours for hysterectomy alone.

On comparing both groups, the researchers found that:

  • Those who underwent a combo procedure had a higher rate of blood clot-related complications called venous thromboembolism (VTE): 3% versus 1%.
  • These patients were more likely to stay in the hospital for three days or longer: 48 percent versus 29 percent.

However, comparison of the matched groups of patients with similar characteristics, revealed that

  • There was no significant difference in VTE risk between the two groups.
  • The difference in wound complications, surgical site infections, medical complications, or total complication rate was negligible.

Commenting on the findings, the lead author said, “This is among the best evidence to date regarding 30-day risk profiles, and the data suggests that the complication rates are comparable for patients undergoing combined hysterectomy and panniculectomy versus hysterectomy alone.”

Many plastic surgery procedures can also be combined. For instance, tummy tuck can be combined with liposuction of the flanks and lower back to enhance the outcome. Though combining procedures would require more extensive surgery and anesthesia time than singular procedures, it has been seen to enhance patient satisfaction with the outcome and less time lost from work. The key to safe treatment and optimal results, however, depends on choosing a plastic surgeon with experience in the specific combination of procedures desired.

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