Revision Abdominoplasty with Truncal Liposculpting: A 10-Year Experience (original) (raw)
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Revista Brasileira de Cirurgia Plástica (RBCP) – Brazilian Journal of Plastic Sugery
Conflitos de interesse: não há. Introduction: Abdominoplasty techniques have constantly evolved since 1899. With modern liposuction techniques, the concept of high-definition liposuction aims to correct stigmas secondary to the procedure, such as a "tense" appearance and lack of natural abdominal convexity and concavity. Methods: Here we propose a technique to redefine the natural abdominal anatomy using traditional lipoabdominoplasty with selective liposuction to achieve more natural-looking surgical results that are reproducible for most patients. This study included 21 abdominoplasty procedures using the described technique performed between November 2018 and May 2019. The technique showed satisfactory ability to achieve a natural abdominal appearance using deep and superficial liposuction in abdominal shadow areas. Conclusion: The study showed that the technique is safe from a vascular point of view and reproducible due to the use of conventional liposuction, which is available to the vast majority of plastic surgeons.
Outcome Analysis of Combined Lipoabdominoplasty versus Conventional Abdominoplasty
Plastic and Reconstructive Surgery, 2008
Background: Abdominoplasty and liposuction have traditionally been separate procedures. The authors performed a retrospective cohort study to evaluate the outcomes of a novel single-stage approach combining extensive lipoplasty with a modified transverse abdominoplasty. Methods: One hundred fourteen patients were evaluated for abdominal contouring. Patients were categorized into four groups: group I (n ϭ 20) received abdominal liposuction only, group II (n ϭ 33) traditional W-pattern incision line abdominoplasty, group III (n ϭ 30) modified transverse incision abdominoplasty, and group IV (n ϭ 31) combined procedure involving widely distributed abdominal liposuction accompanied by inverted V-pattern dissection abdominoplasty. Wound complications, patient satisfaction, and revision rates were compared statistically. Results: Group I (liposuction alone) experienced an overall complication rate of 5 percent; two patients were dissatisfied (10 percent) and underwent further revision with full abdominoplasties. Group II (traditional W-pattern abdominoplasty) had a complication rate of 42 percent, a dissatisfaction rate of 42 percent, and a revision rate of 39 percent. By comparison, group III (modified low transverse abdominoplasty) had a complication rate of 17 percent, a dissatisfaction rate of 37 percent, and a revision rate of 33 percent. Group IV (combined liposuction plus abdominoplasty) had significantly lower complication, dissatisfaction, and revision rates (9, 3, and 3 percent, respectively). Conclusions: Modified transverse abdominoplasty combined with extensive liposuction and limited paramedian supraumbilical dissection produced fewer complications and less dissatisfaction than did traditional abdominoplasty. This may be attributable to a reduced tension midline closure in the suprapubic region, less lateral undermining in the upper abdomen, and greater preservation of intercostal artery blood flow to the flap.
The reverse lip design: a design for safe and effective abdominoplasty
Archives of Aesthetic Plastic Surgery, 2021
Conventional abdominoplasty includes the removal of an ellipse-shaped section of abdominal tissue between the umbilicus and mons pubis. However, this method can result in tension of the undermined flap, especially in the midline. To address this problem, we present reverse lip design as a modified method that also has aesthetic advantages. The reverse lip design entails a longer lower flap edge while preserving the triangular tissue in the vascularly stable pubis area. These markings create an image of a reverse lip shape with a cleft at the bottom of the lower markings. After typical lipoabdominoplasty is performed, redundant waist tissues can easily be pulled inward and downward. The reverse lip design abdominoplasty demonstrated no complications and required no further revisions after the procedure. Patients were generally satisfied with the aesthetic improvements in their body shape. They were also able to return to their routine activities approximately 1 week after the operati...
Abdominoplasty with anchor plication and complete lipoplasty
Aesthetic Surgery Journal, 2004
Background: Combined abdominoplasty and lipoplasty is frequently performed to achieve improved body contour in a single surgical session. Objective: We describe a procedure that combines vertical and transverse plication of the abdominal fascia with lipoplasty of the anterior abdominal wall. Methods: Lipoplasty of the anterior abdominal wall was performed using a superwet technique. The amount of extracted fat ranged from 200 to 6000 mL. Abdominoplasty was performed using traditional methods. Plication of the abdominal fascia combined the traditional longitudinal method with a half-moon plication, located in the lower abdomen. Results: Seventy-six women ranging in age from 20 to 62 years underwent combined abdominoplasty and lipoplasty between January 2002 and January 2003. Patient satisfaction was rated as excellent in 74 cases. Patient satisfaction was rated as good in the other 2 cases, in which the only patient complaint was hypertrophy of the scar, which improved over time with the use of massage. Seromas developed in 8 patients (10.52%) and were treated successfully by syringe extraction. Conclusions: Benefits of combining abdominoplasty with lipoplasty include reduction of abdominal flap volume, improvement in the final quality of the scar, and improved tissue contraction. The anchor plication reduces strain in the abdominal fascia and also diminishes the vertical abdominal diameter, facilitating the descent of the flap.
Evidence-Based Abdominoplasty Review with Body Contouring Algorithm
Aesthetic Surgery Journal
Abdominal contour deformities are an aesthetic challenge to the plastic surgeon. Patients present with diverse clinical histories, multiple comorbidities, and unique aesthetic demands. Weight loss, previous pregnancy, and aging are 3 principal indications for abdominoplasty. Bariatric surgery has increased demand for body contouring procedures. This heterogeneous patient cohort means a "one-size-fits-all" abdominoplasty is not appropriate. Precise evaluation, evidence-based decision-making, and artistic acumen are required while balancing patient goals with safe, realistic, and long-lasting aesthetic outcomes. This article reviews surgical options for abdominal body contouring, providing an evidence-based treatment algorithm for selecting the appropriate procedure for each patient to maximize clinical and patient reported outcomes.
Abdominoplasty and Abdominal Contour Surgery: A National Plastic Surgery Survey
Plastic and Reconstructive Surgery, 2007
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 ϭ 7010) were liposuction of the abdomen, 10 percent (n ϭ 2003) were limited abdominoplasties, and 55 percent (n ϭ 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.