Abdominoplasty without panniculus undermining enables treatment of localized adiposity and excess abdominal wall skin as well as reinforcement of the muscular aponeurotic structures while significantly reducing the risk of seroma formation and other complications. The technique is not indicated for cases where complex reconstruction of the abdominal aponeurotic wall is necessary. (Aesthetic Surg J 2002;22:16-25.).

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The distribution of the fat tissue in the subcutaneous layer is described. Since it has specific characteristics in each region of the human body, careful evaluation of the distribution before selecting patients for surgery is necessary. The subcutaneous tissue after an operation frequently demonstrates a thick and hard fibrosis which is evidence that liposuction should be performed in the lamellar layers. This type of fibrotic tissue in the subcutaneous areola layer often brings on irregularities and ungraceful waves on the skin surface.

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The author describes an abdominoplasty emphasizing preparation of the abdominal flap, reinforcement of the muscular aponeurotic wall, treatment of the excess of cutaneous tegument, and careful handling of the umbilicus. He makes three umbilical flaps which are alternately stitched to three other flaps originating on the abdominal wall, which result in a scar hidden inside the umbilicus.