Changes in the Pattern of Superficial Lymphatic Drainage of the Abdomen after Abdominoplasty

Abstract

Background:The changes in the pattern of lymphatic drainage of the superficial abdominal wall after abdominoplasty are still unknown. These changes may increase the risk of numerous complications, including seroma formation. Depending on the alterations, the manual lymphatic drainage technique should be modified in postoperative patients. The aim of this study was to map the pattern of lymphatic drainage of the superficial infraumbilical abdominal wall after abdominoplasty. Methods: Twenty women with indications for abdominoplasty were selected in the Plastic Surgery Division of the Federal University of São Paulo. Intradermal lymphoscintigraphy with dextran 500-99m-technetium was performed in 20 female patients in the preoperative phase and 1 and 6 months after abdominoplasty to evaluate superficial lymphatic drainage of the abdominal wall. Results: Before surgery, all patients presented with abdominal lymphatic drainage toward the inguinal lymph nodes. One and 6 months after abdominoplasty, only 15 percent exhibited the same drainage pathway. Drainage toward the axillary lymph node chain occurred in 65 percent of the patients, 10 percent displayed a drainage pathway toward both the axillary and inguinal lymph nodes, and lymphatic drainage was indeterminate in 10 percent of the cases. Conclusions: A significant change in lymphatic drainage pathway occurred in the infraumbilical region after abdominoplasty. The axillary drainage path was predominant after the operation, in contrast to the inguinal path observed in the preoperative period. However, 35 percent of cases exhibited alternative drainage. No significant changes were documented between 1 and 6 months postoperatively.

Effectiveness of Manual Lymphatic Drainage in the Postoperative Period of Abdomen Liposuction

“…Esta técnica de massagem é geralmente indicada para reduzir o edema (inchaço), acelerar o processo de cicatrização, diminuir a formação de fibrose (nódulos duros de tecido cicatricial) e melhorar a textura da pele. Além disso, estudos mostram que o DLM pode ser benéfico em reduzir a dor e a sensibilidade na área tratada, proporcionando uma recuperação mais confortável e agradável para o paciente 8 .…”

Detection of Lymphatic Vessels in the Superficial Fascia of the Abdomen

“…Bassalobre et al [ 33 ] showed that significant changes in the lymphatic drainage pathways occurred in the infraumbilical region after abdominoplasty, with the axillary drainage path predominating after the surgery, in contrast to the inguinal path observed in the preoperative period.…”

The Utility of Lymphatic Massage in Cosmetic Procedures

“… 26 In abdominoplasty, it has been demonstrated that the primary source of lymphatic drainage may shift from inguinal to axillary after undergoing surgery, also placing one at an elevated risk for stasis and potential edema. 27 Lymphedema stemming from cosmetic procedures presents a significant burden to patients who are seeking improved aesthetics by means of often elective procedures, as it can negatively affect comfort, quality of life, and activities of daily living. 28 Numerous studies have found that MLD in conjunction with therapeutic adjuncts can provide reductions in edema, fibrosis, as well as provided analgesia in patients undergoing liposuction and/or lipoabdominoplasty.…”