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Thighplasty: Complication Rates, Risk Factors and Analysis of Concurrent Cosmetic Surgical Procedures
Ashkan Afshari, MD1, Varun Gupta, MD1, Lyly Nguyen, MD1, R. Bruce Shack, MD1, James C. Grotting, MD2, K. Kye Higdon, MD1.
1Vanderbilt University, Nashville, TN, USA, 2University of Alabama, Birmingham, AL, USA.

PURPOSE: Despite a rise in thighplasty, outcomes and risk factors have not been well described. This study investigates the incidence and risk factors of major complications, and the safety of combining procedures with thighplasty in a large, prospective, multi-center database.
METHODS: Patients undergoing thighplasty between 2008-2013 were identified within the CosmetAssure database. The primary outcome was the occurrence of major complication(s) requiring emergency department visit, hospital admission, or reoperation within 30-days postoperatively. Age, gender, BMI, smoking, diabetes, type of facility and combination procedures were evaluated as risk factors.
RESULTS: Among the 129,007 patients enrolled in CosmetAssure, 1,493 (0.8%) underwent thighplasty. 1,088 (72.9%) thighplasties were combined with other procedures. 99 (6.6%) developed at least one complication. The most common complications were infection (2.7%), hematoma (2.1%), suspected/confirmed VTE (1.4%), and fluid overload (0.5%), which were higher than non-thighplasty patients. Hospital-based thighplasties had higher complications (8.1%) than ambulatory surgical center (ACS, 6.2%) and office-based surgical suite (OBSS, 3.1%). When thighplasty was performed alone, smoking was an independent risk factor to develop at least one complication (RR=9.51) and hematoma (RR=13.48). Concomitant lower body lift increased complication risk (11.8% vs 4.7%).
CONCLUSION: Thighplasty has a higher major complication rate compared to most other cosmetic procedures, but lower than previously thought. In thighplasty alone, smoking is the only independent risk factor for overall complications and hematoma formation. Thighplasties performed in OBSS have lower complications rates. There was no complication difference between single or combined procedures except when lower body lift was included as a concomitant procedure.


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