Concurrent abdominal body contouring and hernia repair are safe choices: An analysis of the 2015-2020 ACS-NSQIP database

Document Type

Journal Article

Publication Date



Journal of plastic, reconstructive & aesthetic surgery : JPRAS






ACS-NSQIP; Abdominal body contouring; Abdominoplasty; Concurrent; Hernia repair; Panniculectomy


BACKGROUND: Concurrent hernia repair (HR) with abdominal body contouring procedures (ABD), panniculectomy, and abdominoplasty, has been discussed as a strategy. The purpose of this study is to evaluate potential medical and surgical complications following concurrent ABD-HR, with a greater emphasis on cosmetic abdominoplasty. METHODS: The 2015-2020 ACS-NSQIP datasets were utilized to identify patients who underwent ABD or ABD-HR. Propensity score (PS) matching was used to reduce selection bias by equating groups (ABD vs. ABD-HR) based on covariates. Bivariate analyses of independent variables by our outcomes of interest were performed using the Pearson Chi-Square and Fisher's Exact tests for categorical variables and the Wilcoxon rank-sum test for continuous variables. RESULTS: Of the 14,115 patients identified in the ACS-NSQIP, 13,634 had ABD, while 481 had both ABD and HR. Following PS-matching of the cohorts, ABD (n = 481) and ABD-HR (n = 481), bivariate analysis of the combination of incisional, umbilical, and epigastric hernias indicated longer operative times (mean: 209.6 min) (P < 0.001) and a longer hospital length of stay (mean: 1.9 days) (P < 0.001). The incidence rate of postoperative complications such as wound dehiscence, deep venous thromboembolism, DVT, unplanned return to the OR within 30 days, and other medical complications revealed no significant differences between the two cohorts. A sub-group analysis of wound complications found no significant difference for any wound type. Analysis was also conducted for each type of hernia separately, yielding the same results. CONCLUSION: Our results show no increase in postoperative morbidity when combining ABD and HR compared to ABD alone, suggesting that these procedures can be safely performed concurrently and regardless of the type of hernia.