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Crowley C, Bank J. Beyond the Breast: Body Contouring in the Context of Abdominally Based Microsurgical Breast Reconstruction. JPRAS Open 2024; 39:121-126. [PMID: 38226355 PMCID: PMC10788364 DOI: 10.1016/j.jpra.2023.11.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2023] [Accepted: 11/26/2023] [Indexed: 01/17/2024] Open
Abstract
With continued advances in abdominally based microsurgical breast reconstruction, the operative goal is no longer the creation of a simple breast mound but rather the formation of an aesthetically pleasing breast. While a substantial body of work has been dedicated to accomplishing this result, a similar progression has yet to be reflected in the literature with regard to the contour and shape of the abdominal donor site. Operative advances including muscle, fascial, and nerve preservation have been effective in minimizing the physiologic donor site morbidity of this procedure but have focused less on its cosmesis. Additionally, the published techniques aimed at the aesthetics of the abdomen have focused on the initial procedure and have not utilized the multistage process of breast reconstruction. In this paper, we will describe our approach to optimize the aesthetic result of the abdomen in abdominally based microsurgical breast reconstruction.
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Affiliation(s)
| | - Jonathan Bank
- New York Breast Reconstruction & Aesthetic Plastic Surgery, 833 Northern BLVD, Suite 160, Great Neck, NY 11021
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Horta R, Domingues CS, Dias CC, Barreiro D. A Ruler for Abdominoplasty Preoperative Markings: The Potential of Best Scar Symmetry. Surg Innov 2021; 29:225-233. [PMID: 34266340 DOI: 10.1177/15533506211033145] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Background. Scar appearance is an important outcome in abdominoplasty surgery, and its asymmetry can have a significant impact on patient and surgeon satisfaction. Here, we compared the scar symmetry reached with a ruler specially designed for the preoperative marking in abdominoplasty to the classic preoperative incision marking. Methods. In this randomized, uni-blind study, 42 patients were allocated to 2 different groups. Group 1 patients had their preoperative marking made by a group of surgeons that used the classic technique as described by Baroudi (n = 21), and Group 2 patients received their preoperative marking by another group of surgeons, using a ruler specially designed to fit the abdominal contour (n = 21). Patients were evaluated using a standard questionnaire that collected information about general patient's characteristics. On the follow-up period, we evaluated the presence of late surgical complications, need for revision surgery, patient's satisfaction concerning the postoperative scar, and 4 distances were measured in both groups to assess symmetry. Statistical analysis was made. Results. A total of 42 patients underwent abdominoplasty and were evaluated on the follow-up period (mean time: 4 months). The mean difference of corresponding measures on each side (A-B vs. A-B' and A-C vs. A-C') was higher in Group 1 comparing to Group 2. The level of correlation between corresponding measurements was higher in Group 2. Better satisfaction regarding the scar symmetry was achieved in Group 2, being this result statistically significant (P = .004). Conclusions. The use of the specialized ruler may help surgeons achieve a better scar symmetry with higher patient satisfaction.
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Affiliation(s)
- Ricardo Horta
- Porto University Medical School, Porto, Portugal.,Department of Community Medicine, Information and Decision in Health, Faculty of Medicine of the University of Porto, Portugal; CINTESIS-Center for Health Technology and Services Research, Porto, Portugal
| | | | - Cláudia C Dias
- Department of Plastic, Aesthetic and Reconstructive Surgery, São João Hospital, Porto University Medical School, Porto, Portugal
| | - Diogo Barreiro
- Department of Community Medicine, Information and Decision in Health, Faculty of Medicine of the University of Porto, Portugal; CINTESIS-Center for Health Technology and Services Research, Porto, Portugal
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Ghosh A, Jayakumar R. Modified abdominoplasty incision for short scar. J Plast Reconstr Aesthet Surg 2012; 65:1753-4. [PMID: 22954592 DOI: 10.1016/j.bjps.2012.08.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2012] [Revised: 07/30/2012] [Accepted: 08/03/2012] [Indexed: 10/27/2022]
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Pechter EA. Instant identification of redundant tissue in abdominoplasty with a marking grid. Aesthet Surg J 2010; 30:571-8. [PMID: 20829255 DOI: 10.1177/1090820x10377148] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND It is generally believed that continuous or discontinuous undermining of an abdominoplasty flap is necessary for its advancement, but it is also recognized that such undermining may increase the risk of ischemic complications. OBJECTIVE The author describes a grid-marking system to quickly identify the redundant tissue in abdominoplasty, making the procedure simpler, safer, and more consistent. METHODS A standardized grid was preoperatively marked on 35 consecutive female abdominoplasty patients to determine the exact pattern and extent of skin resection at the beginning of the procedure. This allowed resection of redundant tissue while confining proximal flap undermining to the minimum amount necessary for diastasis repair and umbilical repositioning. RESULTS The 35 patients who underwent abdominoplasty with the author's technique were followed from three months to 2.5 years. Of these, 12 underwent simultaneous liposuction. All procedures were performed on an outpatient basis under general anesthesia in an accredited office operating facility. Overall results were excellent, with no flap ischemia or other complications directly related to wound tension or to limited undermining. CONCLUSIONS A standardized grid system allows identification of redundant abdominoplasty tissue before any incisions are made, which limits undermining to the area over the medial rectus abdominis muscles, the minimum amount necessary for diastasis repair and umbilical repositioning. Simultaneous liposuction can be performed with relative safety, although it is not required for flap advancement.
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Loustau HD, Mayer HF. An abdominoplasty incision according to fashion trends. J Plast Reconstr Aesthet Surg 2010; 63:e317-8. [DOI: 10.1016/j.bjps.2009.06.042] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2008] [Revised: 06/18/2009] [Accepted: 06/26/2009] [Indexed: 11/29/2022]
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Lipoabdominoplasty: revisiting the superior pull-down abdominal flap and new approaches. Aesthetic Plast Surg 2009; 33:366-76. [PMID: 19296152 PMCID: PMC2693800 DOI: 10.1007/s00266-009-9318-z] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2008] [Accepted: 01/22/2009] [Indexed: 10/31/2022]
Abstract
Abdominoplasty is a very common procedure, especially for patients with abdominal laxness, striaes, and muscle rectus diastases. With the advent of liposuction 28 years ago, we can improve body contouring by treating lipodystrophies in the epigastric, flank, trochanteric, and buttocks areas. The procedure combining abdominoplasty and liposuction is called lipoabdominoplasty. Many new techniques have been proposed since these procedures were introduced; we now revisit the superior pull-down abdominal flap technique with several new modifications and improvements.
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Treating the Abdominotorso Region of the Massive Weight Loss Patient: An Algorithmic Approach. Plast Reconstr Surg 2008; 121:1431-1441. [DOI: 10.1097/01.prs.0000302463.55208.bf] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
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8
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Abstract
BACKGROUND A variety of designs have been described for skin resection in abdominoplasty, but all have in common the need for intraoperative modification. Comparison of the different techniques is problematic because the actual skin resection may differ from the preoperative design. In addition, it may be difficult to achieve a symmetrical result, given the shifting bulk of the skin and soft tissue and the differences between the upright and supine patient. METHODS This article describes a standardized grid pattern drawn on the abdomen preoperatively that promotes symmetry and allows postoperative determination of the exact extent of skin resection. Preliminary stapling fundamentally changes the sequence of the procedure by eliminating the conventional first step of flap elevation. RESULTS The technique was used on 31 patients from January of 2004 through May of 2005. Body mass index ranged from 19.1 to 33.1, with an average of 24.4. All procedures were performed under general anesthesia in an accredited office operating facility on an outpatient basis. Details of the technique and representative cases are shown. CONCLUSIONS Use of the grid pattern allows more meaningful comparison of different techniques and gives the surgeon more insight into his or her own technique. When combined with temporary intraoperative skin stapling, it maximizes symmetry of the results, facilitates precise scar placement, and minimizes the need for modifications such as chasing dog-ears. Stapling also allows identification of the proper amount of safe tissue resection at the beginning of the procedure, allowing the redundant tissue to be removed without first being elevated as a cumbersome flap.
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Abstract
We analyzed 80 patients who underwent abdominoplasty at the University of Tor Vergata "Policlinico Casilino", Rome to determine the effect of obesity on the incidence of complications after this surgery. The study patients were divided into 3 groups, obese, overweight, and normal weight, based on the degree to which their preoperative weights varied from their ideal body weight. A history of previous bariatric surgery was also analyzed to determine what impact that might have on subsequent abdominoplasty. Results showed that the records of 80 patients who underwent an abdominoplasty at University of Tor Vergata Policlinico indicated that 76% of obese patients had complications compared with the overweight and normal-weight patients, who had complication rates of 35% and 33%, respectively. Previous gastric bypass surgery had no significant effect on the incidence of postabdominoplasty complications. Based on these findings, the authors conclude that obesity at the time of abdominoplasty has a profound influence on the wound complication rate following surgery, regardless of any previous weight-reduction surgery.
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Affiliation(s)
- M Rogliani
- Faculty of Plastic and Reconstructive Surgery, University of Studies of Rome Tor Vergata, Rome, Italy
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Roje Z, Roje Z, Karanović N, Utrobicić I. Abdominoplasty complications: a comprehensive approach for the treatment of chronic seroma with pseudobursa. Aesthetic Plast Surg 2006; 30:611-5. [PMID: 16977373 DOI: 10.1007/s00266-004-0142-1] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2004] [Accepted: 12/14/2004] [Indexed: 10/24/2022]
Abstract
Abdominoplasty is an extensive surgical operation, often followed by a significant number of local and general complications. Some studies indicate that the risk of severe complications, including mortality, ranges from 1 in 617 to 1 in 2,320 cases. Seroma is one of the serious consequences that follows each type of abdominal contour surgery, from suction-assisted lipoplasty to standard and limited abdominoplasty. A case of a 46-year-old women who underwent standard abdominoplasty and liposuction during the same procedure is presented. In the follow-up examination, a chronic seroma with pseudobursa was observed. The pseudobursa was evacuated multiple times under ultrasound control. During one evacuation, 2,010 ml of seroma was evacuated. Because of the prolonged Seroma formation, the pseudobursa grew, creating a tumor-like effect in the front abdominal wall. In a second operation (miniabdominoplasty), the pseudobursa was completely excised, and the material was sent for analysis. Progressive tension sutures were placed in additional lines to decrease the dead space, and to decrease movement between the abdominal flap and the musculoaponeurotic layer, as suggested by Saltz and Matarasso. Suction drainage with a compressive girdle was maintained for 2 weeks after the second operation. The follow-up assessment, performed 3 months after the second operation, showed no infection, skin necrosis, hernia formation, or new chronic seroma with pseudobursa.
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Affiliation(s)
- Zdravko Roje
- Division of Plastic Surgery Burns, Department of Surgery, University Hospital Split, Soltanska 1, 21000 Split, Croatia.
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Matarasso A, Swift RW, Rankin M. Abdominoplasty and Abdominal Contour Surgery: A National Plastic Surgery Survey. Plast Reconstr Surg 2006; 117:1797-808. [PMID: 16651953 DOI: 10.1097/01.prs.0000209918.55752.f3] [Citation(s) in RCA: 113] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND According to the American Society for Aesthetic Plastic Surgery's 2004 Cosmetic Surgery National Data Bank, during the last 7 years, the number of abdominoplasty procedures performed has increased 344 percent. A national report on abdominoplasty has not been since 1977. Grazer and Goldwyn's study reflects the preliposuction era of abdominal contouring surgery. The purpose of this study was to assess current trends in abdominal contouring techniques and associated procedures and the incidence of their complications. METHODS The study was designed as a descriptive correlation survey evaluating the frequency of various abdominal contour techniques and complications among 3300 randomly chosen members of the American Society of Plastic Surgeons. There were 497 respondents, for a response rate of 15 percent. RESULTS A total of 20,029 procedures were reported in the survey; 35 percent (n = 7010) were liposuction of the abdomen, 10 percent (n = 2003) were limited abdominoplasties, and 55 percent (n = 11,016) were full abdominoplasties. Survey data covered the plastic surgeon's demographics, techniques, and incidence of complications during a 12-month period. CONCLUSIONS The authors report the largest series of local and systemic complication rates and compare them with those of previously published abdominoplasty surveys. With respect to full abdominoplasty, lower complication rates for deep vein thrombosis (0.04 percent) and pulmonary embolus (0.02 percent) were seen. No deaths were reported. There was no correlation between a surgeon's years in practice and complication rates, in concordance with the earlier study by Grazer and Goldwyn. Despite more extensive abdominal contouring techniques and the addition of liposuction to abdominal contouring, the local and systemic complication rates coincided with previous complication rates, as outlined in other studies.
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Graf R, de Araujo LRR, Rippel R, Neto LG, Pace DT, Cruz GA. Lipoabdominoplasty: liposuction with reduced undermining and traditional abdominal skin flap resection. Aesthetic Plast Surg 2006; 30:1-8. [PMID: 16404652 DOI: 10.1007/s00266-004-0084-7] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Abdominoplasty surgery has spread universally, as both an aesthetic and a reconstructive procedure, and new techniques are appearing with the goal of minimizing ischemic complications of the flap and bettering body contour. The purpose of this article is to demonstrate that an abdominoplasty technique with limited undermining and preservation of the flap perforator vessels makes it possible to reduce the complication rate attributable to flap necrosis and seroma in abdominoplasty. Doppler flowmetry color study of the abdominal wall was performed before the surgical procedure and on postoperative day 15 after lipoabdominoplasty for a series of 20 patients to evaluate the blood supply of the abdominal wall. This study confirmed the preservation of perforator arteries in the periumbilicus area and right upper quadrant after abdominoplasty with liposuction and reduced undermining.
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Affiliation(s)
- Ruth Graf
- Rua Solimóes 1184, Curitiba, Paraná, PR, 80810-070, Brazil.
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Cárdenas-Camarena L. Aesthetic Surgery of the Thoracoabdominal Area Combining Abdominoplasty and Circumferential Lipoplasty: 7 Years?? Experience. Plast Reconstr Surg 2005; 116:881-90; discussion 891-2. [PMID: 16141832 DOI: 10.1097/01.prs.0000176898.98315.2f] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Aesthetic surgery of the thoracoabdominal area combining abdominoplasty and circumferential lipoplasty during the same surgical procedure is not a very common surgical procedure, but its use has increased during recent years. The authors present their surgical technique combining abdominoplasty and circumferential liposuction to improve body shape, emphasizing how complications can be prevented. METHODS The authors present a 7-year experience combining abdominoplasty and circumferential liposuction. The authors operated on 310 female patients between 26 and 64 years of age (mean, 38 years), weighing between 51 and 113 kg (mean, 76 kg); 86 percent of them were overweight. During the surgical procedure, the authors performed abdominoplasty combined with posterior, lateral, and anterolateral suction-assisted lipoplasty. The abdominoplasty was performed with minimal superior undermining, performing only that necessary to permit muscle plication, preserving maximal blood supply to the distal flap. RESULTS One thousand five hundred to 8200 ml of fat was obtained with liposuction (mean, 3700 ml) and 380 to 5100 g was eliminated on the abdominal flap (mean, 870 g). Sixty-three patients (20.3 percent) had minor complications and four patients (1.3 percent) had major complications. CONCLUSIONS The combination of abdominoplasty and circumferential liposuction permits excellent body contouring in a single surgical procedure with minimal complications.
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Matarasso A, Wallach SG, Rankin M, Galiano RD. Secondary Abdominal Contour Surgery: A Review of Early and Late Reoperative Surgery. Plast Reconstr Surg 2005; 115:627-32. [PMID: 15692375 DOI: 10.1097/01.prs.0000150154.36846.7b] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
A retrospective chart review of 400 abdominal contour operations produced a series of 24 patients who underwent both their primary and then their secondary abdominal contour surgeries with the senior author (Matarasso). The majority of patients were classified and treated according to the abdominoplasty classification system previously described; however, a subgroup could not be categorized according to this system. In this study, the authors identified the secondary abdominal contour surgical experience of one surgeon. A comparison was made between two groups of patients treated for both primary and secondary operations: group I, considered early, less than 18 months after the previous operation; and group II, considered late, 18 or more months after the previous operation. There was a significant difference between groups I and II (chi2 = 4.12, p = 0.05); most patients had their surgical procedures before 18 months. For patients who underwent either a miniabdominoplasty or a full primary abdominoplasty, there was a statistically significant difference between the number of patients treated in group I and the number in group II (Fisher's exact test, D = 0, p = 0.05). Next, the nature of the secondary procedure was determined to be either a revisional procedure or a completely new reoperative procedure. The majority of patients underwent revision or "touch-ups," accomplished with either liposuction alone or in combination with scar revision. There was no significant difference between types of primary and secondary procedures performed in group I or group II. Secondary abdominal contour surgery accounted for 6 percent (24 of 400) of all abdominal contour procedures performed by one surgeon. Complete secondary surgery, performing an additional open procedure, occurred in 21 percent of cases (five of 24). Revision surgery (scar revision or removal of dog-ears) was performed in 29 percent of all cases (seven of 24). There was a 4 percent (one of 24) complication rate requiring operative intervention. This rate is consistent with that reported in the literature for primary abdominal contour surgery. With the overall acceptance of aesthetic surgery increasing, the number of patients undergoing abdominoplasty increasing, an aging population, and the safety of secondary abdominal contour surgery suggested from this review, it is likely that plastic surgeons will see more patients requesting secondary abdominal contour surgery in the future.
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Affiliation(s)
- Alan Matarasso
- Department of Plastic Surgery, Albert Einstein College of Medicine and Manhattan Eye, Ear, and Throat Hospital, New York, NY, USA
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Abstract
Men have a larger body surface area, distinguishing physical characteristics, and unique aesthetic concerns that present a different therapeutic challenge from women. The primary area of disappointment in males is the inability to alter the intra-abdominal submuscular fat compartment where fat redistributes with advancing age, resulting in enlarged abdominal girth. In general, men who have not experienced large weight fluctuations present with skin of good quality and tone and can benefit from liposuction surgery; those who have poor skin tone, with or without rectus muscle diastasis, may be candidates for a full abdominoplasty or a pannilectomy with liposuction. These procedures represent the overwhelming majority of abdominal contour operations performed in males.
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Affiliation(s)
- Alan Matarasso
- Albert Einstein College of Medicine, 1300 Morris Park Avenue, Bronx, NY 10461-1975, USA.
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Duff CG, Aslam S, Griffiths RW. Fleur-de-Lys abdominoplasty--a consecutive case series. BRITISH JOURNAL OF PLASTIC SURGERY 2003; 56:557-66. [PMID: 12946374 DOI: 10.1016/s0007-1226(03)00174-7] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
Sixty-eight consecutive patients who had undergone Fleur-de-Lys abdominoplasty are described. The mean age was 39 years, (22-62 years) and the mean body mass index (BMI) was 29 kg/m(2) (17-47 kg/m(2)). Forty patients had documented weight loss, mean 39 kg (10-103 kg). The operation duration ranged from 1 h 10 min to 4 h 15 min. The mean mass of tissue resected was 2.4 kg, (0.3-9.1 kg). The overall complication rate was 42/68 (62%) and complications were categorised as early, late, general and aesthetic. Complications were significantly related to patients with a greater age (p=0.0091), increasing BMI (p=0.0039), greater weight (p=0.0014) and greater mass of tissue resected (p=0.0002). There was no significant association between smoking and complications. There was no significant association between previous gastric partitioning surgery and complications. Despite the significant complication rate, a single operation achieved a satisfactory outcome in 82% of patients. Our data reinforce findings from previous studies, which have demonstrated that patients should be required to reduce weight prior to body contouring surgery.
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Affiliation(s)
- C G Duff
- Department of Plastic, Burn and Reconstructive Surgery, Northern General Hospital, Herries Road, Sheffield S5 7AU, UK.
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Saldanha OR, De Souza Pinto EB, Mattos WN, Pazetti CE, Lopes Bello EM, Rojas Y, dos Santos MR, de Carvalho ACO, Filho ORS. Lipoabdominoplasty with selective and safe undermining. Aesthetic Plast Surg 2003; 27:322-7. [PMID: 15058559 DOI: 10.1007/s00266-003-3016-z] [Citation(s) in RCA: 77] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Our objective is to present a new surgical concept for the aesthetic treatment of the abdominal region using the principles of liposuction associated with the traditional abdominoplasty. Lipoabdominoplasty is different from other techniques because it has the advantages of conserving perforator vessels of the abdominal wall, it preserves suprapubic sensibility, results in better abdominal contouring, has a low rate of complications, and a faster recuperation after surgery. The traditional abdominoplasty has been used for many years with several modifications intending to achieve better aesthetic contouring and to reduce complications. However, each modification solves problems only partially. The authors perform the surgery beginning with wet lipoplasty in superficial and deep fat layers. The skin below the umbilical scar is excised as in classical abdominoplasty. After that, selective and safe undermining of the dermocutaneous flap is done in the middle section of the upper abdomen between the borders of the rectus abdominis muscle, preserving mainly supply vessels of the abdominal wall.
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Abstract
When performing traditional abdominoplasty, three fundamental defects of the abdominal wall must always be addressed by the plastic surgeon. They include redundant skin, excess fat, and musculofascial laxity. Plastic surgeons have found that this procedure consists of dermolipectomy and rectus plication, extremely effective in restoring the abdomen to its youthful shape in the vast majority of patients. This article will review the recent advancements in body contouring surgery while focusing on the recent technical refinements in abdominoplasty.
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Affiliation(s)
- O Seung-Jun
- Division of Plastic Surgery, University of Miami School of Medicine, Florida 33136-1094, USA
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21
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Matarasso A. Liposuction as an adjunct to a full abdominoplasty revisited. Plast Reconstr Surg 2000; 106:1197-1202; discussion 1203-5. [PMID: 11039391 DOI: 10.1097/00006534-200010000-00035] [Citation(s) in RCA: 73] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Abstract
BACKGROUND Abdominal surgery has evolved from one operation applied to all patients requesting contouring, to a group of procedures based on individual variations in anatomy. Currently, the authors favor four (Types I-IV) different procedures. Liposuction alone (Type I) is performed in the majority of patients. In the remainder (procedures Type II-IV) liposuction combined with modifications of open, traditional abdominoplasty are utilized. These additional methods are appropriate in patients that necessitate rectus muscle reinforcement or skin reduction procedures in order to adequately contour the abdomen. OBJECTIVE This report describes the indications for abdominal contour surgery, beyond just liposuction. METHODS A consecutive series of over 300 abdominal contour patients were reviewed and analyzed, with recommendations based on individual variations in their soft tissue anatomy. RESULTS We demonstrate that the majority of patients benefit from a "closed" procedure (liposuction or ultrasonic assisted liposuction) but that patients with muscle flaccidity or laxity in their skin may require an open procedure. CONCLUSION Abdominal contour surgery should be considered a group of operations (abdominolipoplasty system of classification and treatment) based on individual varieties in anatomy.
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Affiliation(s)
- A Matarasso
- Department of Plastic Surgery, Albert Einstein College of Medicine, New York, NY, USA
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al-Qattan MM. Abdominoplasty in multiparous women with severe musculoaponeurotic laxity. BRITISH JOURNAL OF PLASTIC SURGERY 1997; 50:450-5. [PMID: 9326149 DOI: 10.1016/s0007-1226(97)90333-7] [Citation(s) in RCA: 45] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
The results and complications of abdominoplasty in 20 consecutive multiparous women with very severe musculoaponeurotic laxity are presented. All patients presented with an abdomen that resembled a full-term pregnancy when the patient was in the erect posture. This very severe laxity was the end result of repeated pregnancies. All patients underwent a standard abdominoplasty with wide longitudinal plication using size 1 prolene sutures. Follow-up averaged 1 year. None of the patients had a major complication. However, all the patients had recurrence of the musculoaponeurotic laxity. Causes and classification of this recurrent laxity are discussed along with possible solutions.
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Affiliation(s)
- M M al-Qattan
- Division of Plastic Surgery, King Saud University, Riyadh, Saudi Arabia
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