Complication Rates of Lipoabdominoplasty versus Traditional Abdominoplasty in High-Risk Patients (original) (raw)
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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.
Aesthetic Plastic Surgery, 2006
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.
Enhancing the Lipoabdominoplasty Results by Preserving Epigastric Perforators
The Egyptian Journal of Plastic and Reconstructive Surgery, 2018
Objectives: Abdominoplasty is one of the most common aesthetic operations. Using selective undermining, it is possible to preserve at least 80 percent of the blood supply in the abdominal wall, preserving the great majority of the lymphatic vessels, and resulting in few complications compared with traditional abdominoplasty. Material and Methods: In this study, lipoabdominoplasty was performed on 10 patients from January 2015 to December 2015. Results: The results are good and excellent, especially regarding patient evaluation, better body contour, shorter scars, the form of the umbilicus, and a decrease in the abdominal measures. With a progressive adaptation of this technique, it is possible to achieve a harmonious body contour using a safe liposuction method on the abdominal and costal areas, with fast recovery and good to excellent results.
Aesthetic surgery journal / the American Society for Aesthetic Plastic surgery, 2015
Subcutaneous surgical drains are commonly used in abdominoplasties to prevent seromas but are not tolerated well by patients and add additional discomfort after the procedure. The lipoabdominoplasty modification may create a more favorable surgical field to reduce the need for surgical drains without increasing seroma formation. The goal of this review was to determine if surgical drains can be completely eliminated in lipoabdominoplasty procedures without an increased risk of seromas. The authors conducted a retrospective chart review of 100 consecutive standard, extended, and circumferential lipoabdominoplasty patients done by a single surgeon with at least a 3-month follow-up period. Seroma was identified in 5% of patients, hematoma and abscess each in 2% of patients, and granuloma, cellulitis, and delayed wound healing each in 1% of patients. The use of discontinuous undermining with liposuction, limited direct undermining in the midline, preservation of a thin layer of fibrofat...
Standards and Trends in Lipoabdominoplasty
Plastic and Reconstructive Surgery Global Open, 2020
Background: Lipoabdominoplasty has evolved over the last 6 decades through contributions from numerous luminaries in plastic and reconstructive surgery. Methods: The authors review historical perspective and provide a contemporary examination of trends in lipoabdominoplasty. Results: In 1967, Pitanguy popularized abdominoplasty (without liposuction) as a technique for augmenting ventral hernias repairs and subsequently for aesthetic improvement of the abdomen. After the introduction of suction assisted lipectomy by Illouz in 1983, abdominoplasty became a central tool in a diverse armamentarium of anterior and lateral abdominal wall contouring procedures. Liposuction was initially utilized with mini-abdominoplasty in order to improve contour. Subsequently, Matarasso advanced the safe combination of liposuction with full abdominoplasty. Additionally, he systematized the variety of cutaneous undermining, excision, and liposuction procedures utilized in abdominal contouring as indicated...
Classification for indications of lipoabdominoplasty and its variations
Aesthetic Surgery Journal, 2006
Background: Lipoabdominoplasty, the combination of lipoplasty with classical abdominoplasty, presents new opportunities for the treatment of abdominal lipodystrophy. Objective: The author analyzed 211 patients who underwent lipoabdominoplasty from 2000 to 2004. Methods: After the preoperative physical examination, the patients were classified into 9 different groups according to the indications for the most appropriate technique in each case. Patient groups ranged from those presenting with mild fat panniculus and good quality skin to massive weight loss patients with a high degree of flaccidity. Techniques used in treating the various patient groups included lipoplasty alone, 3 variations of lipominiabdominoplasty, 4 variations of lipoabdominoplasty, and abdominoplasty alone. The surgical principles used in the variations of lipoabdominoplasty included dissection and sculpturing of the subcutaneous deep layer and superficial layer through lipoplasty, selective undermining and plication of the anterior rectus sheath, preservation of the perforator vessels, preservation of Scarpa's fascia and deep fat, skin resection, and umbilical transposition. Results: Two hundred eleven patients were treated between January 2000 and May 2004. Results were good, with high patient satisfaction regardless of variations in technique.
Abdominoplasty techniques have evolved with our improved understanding of vascular anatomy, tissue mechanics, and patient preferences. As a result, today, surgeons are well equipped with an armamentarium of evidence-based techniques and adjuncts that safely and effectively address abdominal lipodystrophy, skin flaccidity, and myofascial laxity. Abdominoplasty is now one of the most common procedures performed by plastic surgeons in the United States, with rates projected to increase with the growing popularity of bariatric surgery, an aging population, and increasing motivation from a generation of patients who have undergone liposuction alone. The present article reviews the authors' current technique.
Lipoabdominoplasty with Selective and Safe Undermining
Aesthetic Plastic Surgery, 2003
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.