A Paradigm Shift for Abdominoplasty: Transverse Hypogastric Plication Without Supraumbilical Dissection, Unrestricted Liposuction, Neoumbilicoplasty, and Low Placement of the Scar (TULUA)

Villegas-Alzate, Francisco J

doi:10.1007/978-3-319-20004-0_15

Cited by 10 publications

(10 citation statements)

References 31 publications

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“…34,35 These physiologic and anatomical variants can now be approached in an innovative way through TULUA modifications and high-definition liposculpture. Although it is not mandatory to make a vertical plication, we recommend a transverse plication of the abdominal wall to relieve the pressure of the skin and improve the neovascularization of the flap, 15,17 making not only the wound closure easier but also allowing a greater muscular definition compared to conventional abdominoplasty. 17 Undermining must not be performed below the umbilicus level and is not necessary until the xiphoid, to avoid flap compromise.…”

Section: Discussionmentioning

confidence: 99%

“…In addition, the vector of correction that redistributes forces over the abdominal wall will lessen the risk of complications such as skin retraction and flap necrosis. 15,17 As a result of the extensive fat removal from deep and superficial layers in the abdominal wall, a three-dimensional sculpture of the underlying superficial musculature is achieved by high-definition liposculpture. Silk references are essential to predict the final location of the rectus abdominis muscle tendinous intersections after abdominoplasty, as in our experience the fascia retracts at the beginning but typically follows the initial markings rather than new ones built by liposculpture.…”

Section: Discussionmentioning

confidence: 99%

“…In addition, the vector of correction that redistributes forces over the abdominal wall will lessen the risk of complications such as skin retraction and flap necrosis. 15,17…”

Section: Discussionmentioning

confidence: 99%

“…Transverse plication is made by facing the borders of the drawn ellipse with interrupted 0 polypropylene stitches and then a running suture for reinforcement. 15,17 [See Video (online), which demonstrates the transverse muscular plication during TULUA HD technique with interrupted figure-of-eight suture. ]…”

Section: Transverse Plicationmentioning

confidence: 99%

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TULUA Male High-Definition Abdominoplasty

Babaitis¹,

Villegas²,

Hoyos³

et al. 2021

Plastic &Amp; Reconstructive Surgery

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emoving fat and skin excess in addition to abdominal muscle diastasis correction are the key components of lipoabdominoplasty, which has widely been reported to improve the patient's quality of life. [1][2][3] Over time, abdominoplasty techniques have constantly been improved since Demars and Marx reported the first dermolipectomy in 1880. 4 Also, Kelly performed a "transverse abdominal lipectomy" in 1899 in the United States. 3,5 Later, new techniques and combined procedures were reported, 3,6 such as the liposuction-assisted abdominoplasty described in 1992 by Background: Abdominoplasty is a surgical technique for body contouring that has been shown to improve the patient's quality of life. It has become more common among male patients, so clear differences between procedures for men and women have to be stated. The authors present their experience with high-definition lipoabdominoplasty with transverse plication in men. Methods: Records of male patients undergoing transverse plication full abdominoplasty in addition to high-definition liposculpture were analyzed. A total of 24 consecutive cases were found between January of 2017 and June of 2019. Patient ages ranged from 24 to 60 years. Patients aged 18 years or younger were excluded. Body mass index ranged from 25 to 33 kg/m 2 . Photographic records were taken before and during follow-up at 2 days and 1, 3, 6, and 12 months after surgery. Results: Male TULUA (transverse plication, no undermining, full liposuction, neoumbilicoplasty, and low transverse abdominal scar) with high-definition lipoabdominoplasty was successfully achieved in 24 cases. No major complications were reported. Six minor complications were reported (25 percent). Rectus abdominis diastases are less common in men compared to women, as pregnancy is the most determining factor in its development. Fat distribution is also a key difference when performing lipoabdominoplasty for the male or the female patient. The authors recommend a transverse plication of the abdominal wall, instead of a vertical one, as flap viability is preserved and enhanced muscular definition can be accomplished. Conclusions: Combining transverse plication with high-definition lipoabdominoplasty (transverse plication, no undermining, full liposuction, neoumbilicoplasty, and low transverse abdominal scar plus high-definition lipoabdominoplasty) is a safe and reproducible technique for the male patient. It offers higher aesthetic results in line with modern beauty ideals. (Plast.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

“…In addition, the vector of correction that redistributes forces over the abdominal wall will lessen the risk of complications such as skin retraction and flap necrosis. 15,17…”

Section: Discussionmentioning

confidence: 99%

Section: Transverse Plicationmentioning

confidence: 99%

See 2 more Smart Citations

TULUA Male High-Definition Abdominoplasty

Babaitis¹,

Villegas²,

Hoyos³

et al. 2021

Plastic &Amp; Reconstructive Surgery

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“…In a previous publication, 14 of 176 patients (7.9 percent) had combined vertical and transverse plication because of pathologic diastasis. 42 Because of hypothetical improved vascular safety, the technique is starting to be used for abdominal etching (TULUA-HD). 18,56 The corresponding author (F.J.V.A.)…”

Section: Discussionmentioning

confidence: 99%

TULUA Lipoabdominoplasty: Transversal Aponeurotic Plication, No Undermining, and Unrestricted Liposuction. A Multicenter Study of 845 Cases

Villegas-Alzate¹,

Blugerman²,

Vera-Cucchiaro³

et al. 2021

Plastic &Amp; Reconstructive Surgery

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Background: TULUA (transverse plication, no undermining, full liposuction, neoumbilicoplasty, and low transverse abdominal scar) is the acronym for a radically different lipoabdominoplasty, intended to add simplicity, improve vascular safety, and attain good results. Modifications are unrestricted liposuction, no flap detachment, massive transverse infraumbilical plication, umbilicus amputation, neoumbilicoplasty, diminished tension wound closure, and low transverse scar settlement. The objectives of this article are to describe the technique and analyze a multicenter experience. Methods: Sixty-eight plastic surgeons from 10 countries provided data for a retrospective review of 845 patients. Aesthetic results were scored by each surgeon using the Salles scale and analyzed in combination with complications to identify associations between patient and surgery characteristics. Results: Of the patients, 95.5 percent were female, 19.7 percent were obese, 35.6 percent had prior scars, 10.4 percent had undergone previous abdominoplasty, 6.5 percent were postbariatric, and 6.6 percent were smokers. One patient had a kidney transplant, and 16.5 percent had comorbidities. Surgery characteristics varied widely, being on average as follows: lipoaspirate, 2967 ml; resection, 1388 g; and surgical time, 3.9 hours; 46.5 percent were not hospitalized. Averaged results were 8.68 of 10 points, besides adequate positioning and proportion of scar and umbilicus, without epigastric compensatory bulging (4.97 of 6 points). Overall complications were 16.2 percent, mostly seroma (8.8 percent); vascular-related complications (i.e., necrosis, wound dehiscence, and infection) constituted 2.7 percent. There were no fatalities. The logistic regression model demonstrated that smoking and obesity duplicate the risk of complications; if age older than 60 years is added, the risk of complication increases seven to nine times. Reported indications were multiple; however, pathologic diastasis was excluded. Conclusion: TULUA lipoabdominoplasty is a new reproducible procedure with good quantified results and an acceptable complication rate.

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Open Diastasis Recti Surgery: Abdominoplasty

Soriano,

Palmisano

2024

New Concepts in Diastasi Recti Surgery

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A Paradigm Shift for Abdominoplasty: Transverse Hypogastric Plication Without Supraumbilical Dissection, Unrestricted Liposuction, Neoumbilicoplasty, and Low Placement of the Scar (TULUA)

Cited by 10 publications

References 31 publications

TULUA Male High-Definition Abdominoplasty

TULUA Male High-Definition Abdominoplasty

TULUA Lipoabdominoplasty: Transversal Aponeurotic Plication, No Undermining, and Unrestricted Liposuction. A Multicenter Study of 845 Cases

Open Diastasis Recti Surgery: Abdominoplasty

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