The Efficacy of Combined Liposuction and Surgical Resection of Deep Fat of the Anterior Abdominal Wall in Abdominoplasty

Azzam, Ehab Z; Salem, Iman L; El Wakeel, Helmy S

doi:10.21608/ejprs.2019.65111

The Efficacy of Combined Liposuction and Surgical Resection of Deep Fat of the Anterior Abdominal Wall in Abdominoplasty

Document Type : Original Article

Authors

The Department of Plastic Surgery, Faculty of Medicine, Alexandria University, Egypt

10.21608/ejprs.2019.65111

Abstract

Background: Correction of abdominal wall deformities
is one of the most frequent procedures in plastic surgery, and
the aesthetic, reconstructive, and functional aspects should
always be considered. Patients seeking abdominoplasty desire
correction of an existing abdominal wall contour deformity
resulting from excess skin and fat as well as musculofascial
laxity. The objective of this study is to evaluate the safety
and outcome of thinning of anterior abdominal wall flap
during abdominoplasty from the aesthetic and the functional
point of view.
Patients and Methods: 20 females complaining of abdominal
lipodystrophy, skin laxity and musculoaponeurotic flaccidity
were subjected to lipoabdominoplasty with direct
surgical resection of the deep fat. Then the results were
evaluated from the aesthetic and functional points of view.
Results: The mean hospital stay was 3.75±0.91 days
(range 3-6 days), two cases were reported with flap dehesince.
(10%) and only one case of seroma was reported (5%). 90%
of cases were satisfied and esthetic results as evaluated by a
senior plastic surgeon not involved in the study were accepted
in 18 cases (90%) of cases.
Conclusion: Lipoabdominoplasty with limited supraumblical
paramedian undermining with thining of the anterior
abdominal wall flap through resection of the deep subscarpal
fat, is a powerful and safe body sculpturing tool that can lead
to better aesthetic and functional results.

Keywords

Main Subjects

Aesthetics

References

Kelly H.: A report of gynecologic diseases (excessive
growth of fat). Johns Hopkins Med. J., 10: 197, 1899.
2- Pitanguy I.: Abdominal lipectomy: An approach to it
through analysis of 300 consecutive cases. Plast. Reconstr.
Surg., 40: 384, 1967.
3- Garrido D.E., Aponte Y.M., Behnam A.B., Keeshin T.,
Sinha V., Evans K.K. and Salgado C.J.: Updates in Abdominal
Wall Reconstruction; Anaplastology, 2: 2161-
1173, 2013.
4- Taylor G.I. and Daniel R.K.: The anatomy of several free
flap donor sites. Plast. Reconstr. Surg., 56: 243, 1975.
5- Hester T.R. Jr., Nahai F., Beegle P.E. and Bostwick J. III.:
Blood supply of the abdomen revisited, with emphasis
on the superficial inferior epigastric artery. Plast. Reconstr.
Surg., 74: 657, 1984.
6- Worseg A.P., Kuzbari R., Hubsch P., et al.: Scarpa's fascia
flap: Anatomic studies and clinical application, Plast.
Reconstr. Surg., 74: 1368, 1984.
7- Brink R.R., Beck J.B. and Anderson C.M.: Abdominoplasty
with direct resection of deep fat. Plast. Reconstr. Surg.,
123: 1597, 2009.
8- Justin B.: Outcome Analysis of Combined Lipoabdominoplasty
versus Conventional Abdominoplasty. Plast.
Reconstr. Surg., 121: 1821, 2008.
9- Saldanha O.R., Pinto E.B., Matos Jr. W.N., Lucon R.L.,
Magalhães F. and Bello E.M.: Lipoabdominoplasty without
undermining. Aesthet. Surg. J., 21 (6): 518-26, 2001.
10- Cardoso De Castro C., Cupello A.M. and Cintra H.:
Limited incisions in abdominoplasty. Ann. Plast. Surg.,
19 (5): 436-47, 1987.
11- Dillerud E.: Abdominoplasty combined with suction
lipoplasty. A study of complications, revisions, and risk
factors in 487 cases. Ann. Plast. Surg., 25 (5): 333-8,
1990.
12- Matarasso A.: Liposuction as an adjunct to full abdominoplasty.
Plast. Reconstr. Surg., 95: 829, 1995.
13- Brauman D.: Liposuction abdominoplasty: An evolving
concept. Plast. Reconstr. Surg., 112: 288, 2003.
14- Song A.Y., Rubin J.P., Thomas V., Dudas J.R., Marra K.G.
and Fernstrom M.H.: Body image and quality of life in
post massive weight loss body contouring patients. Obesity,
14 (9): 1626-36, 2006.
15- Stuerz K., Piza H. and Kinzl J.F.: The impact of abdominoplasty
after massive weight loss: A qualitative study.
Ann. Plast. Surg., 71 (5): 547-9, 2013.
16- Papadopulos N.A., Staffler V., Mirceva V., Henrich G.,
Papadopoulos O.N., Kovacs L., et al.: Does abdominoplasty
have a positive infl uence on quality of life, selfesteem,
and emotional stability? Plast. Reconstr. Surg.,
129 (6): 957-62, 2012.
17- Hensel J.M., Lehman J.A., Tantri M.P., Parker M.G.,
Wagner D.S. and Topham N.S.: An outcomes analysis
and satisfaction survey of 199 consecutive abdominoplasties.
Ann. Plast. Surg., 46 (4): 357-63, 2001