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      Benchmarking outcomes in plastic surgery: national complication rates for abdominoplasty and breast augmentation.

      Plastic and Reconstructive Surgery
      Abdominal Wall, surgery, Adult, Benchmarking, Breast Implantation, adverse effects, methods, Breast Implants, Chi-Square Distribution, Combined Modality Therapy, Databases, Factual, Esthetics, Female, Follow-Up Studies, Humans, Incidence, Lipectomy, Male, Middle Aged, Patient Satisfaction, Postoperative Complications, epidemiology, physiopathology, Probability, Retrospective Studies, Risk Assessment, Surgery, Plastic, trends, Treatment Outcome, United States

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          Abstract

          The authors evaluated the use of national databases to track surgical complications among abdominoplasty and breast augmentation patients. Their study population included all patients with abdominoplasty or breast augmentation in the Tracking Operations and Outcomes for Plastic Surgeons (TOPS) and CosmetAssure databases from 2003 to 2007. They evaluated the incidence of hematoma, infection, and/or deep venous thrombosis/pulmonary embolism. Chi-square and t tests were used for the analyses. The TOPS and CosmetAssure databases included 7310 and 3350 patients with abdominoplasty and 30,831 and 14,227 patients with breast augmentation, respectively. In the TOPS and CosmetAssure populations, the complication rates for abdominoplasty were 0.9 percent and 0.5 percent with hematoma (p = 0.29), 3.5 percent and 0.7 percent with infection (p < 0.001), and 0.3 percent and 0.1 percent with deep venous thrombosis/pulmonary embolism (p = 0.05), respectively. The complication rates for breast augmentation in TOPS and CosmetAssure were 0.6 percent and 0.7 percent with hematoma (p = 0.21), 0.3 percent and 0.1 percent with infection (p < 0.001), and 0.02 percent and less than 0.01 percent with deep venous thrombosis/pulmonary embolism (p = 0.31), respectively. Complication rates for abdominoplasty and breast augmentation were similar in TOPS and CosmetAssure, providing a measure of cross-validation. The low complication rates support the safety of these procedures when they are performed by plastic surgeons. These data should be used by individual practitioners for outcomes benchmarking.

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