Circumferential Contouring of the Lower Trunk: Indications, Operative Techniques, and Outcomes—A Systematic Review

Carloni, Raphaël; Runz, Antoine De; Chaput, Benoît; Herlin, Christian; Girard, Paul; Watier, Éric; Bertheuil, Nicolas

doi:10.1007/s00266-016-0660-7

Cited by 34 publications

(16 citation statements)

References 87 publications

(278 reference statements)

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“…In severe cases, patients may be best served with fleur-de-lis abdominoplasty, corset abdominoplasty, or circumferential body lift procedures, which are powerful techniques that fall outside the purview of standard lipoabdominoplasty discussion and require additional operative and post-operative considerations. 72 – 74 For MWL patients with moderate deformities, abdominoplasty has been shown to provide significant psychosocial and functional improvement. 67 , 68 , 75 Importantly, excision of redundant skin provides the greatest utility for patients in this population, while rectus plication may not be critical to achieving a satisfactory result.…”

Section: Novel Trends In Lipoabdominoplastymentioning

confidence: 99%

Standards and Trends in Lipoabdominoplasty

O’Kelly¹,

Nguyen²,

Gibstein³

et al. 2020

Plastic and Reconstructive Surgery - Global Open

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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 by the degree of skin laxity and musculofascial diastasis. Lockwood advocated high lateral tension closure of the superficial fascial system of the abdomen to improve the contour of the hips and flanks. Saldanha advanced selective undermining and anterior abdominal wall perforator preservation to minimize wound healing and seroma complications associated with lipoabdominoplasty procedures. Conclusion: In abdominal contour surgery, surgeons can rely on classic techniques and algorithms that have withstood the test of time while modifying their approaches with advances backed by compelling and rigorously obtained evidence.

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Section: Novel Trends In Lipoabdominoplastymentioning

confidence: 99%

Standards and Trends in Lipoabdominoplasty

O’Kelly¹,

Nguyen²,

Gibstein³

et al. 2020

Plastic and Reconstructive Surgery - Global Open

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“…Two surgeon model. 7,11,12,14,15,23 Limited tubes and drains (eg, no Foley; JP drains). 103-105 Immediate extubation with prompt emergence from general anesthesia (if required).…”

Section: Eras Bl Protocolmentioning

confidence: 99%

“…The long duration of operative time, complex anesthesia management, prolonged postoperative convalescence, and high rates of major and minor complications (24%-78%) associated with inpatient management justifiably delayed consideration of these procedures for outpatient care. 1-25…”

Section: Introductionmentioning

confidence: 99%

“…Cost containment may therefore be paramount in patient’s consideration for elective surgical management after weight loss. This includes the costs related to complications 11,12 of the primary surgery. Here, we present our ERAS protocol for safe and efficient outpatient BL surgery, which has resulted in unprecedented safety and high patient satisfaction with lower costs.…”

Section: Introductionmentioning

confidence: 99%

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An Enhanced Recovery After Surgery (ERAS) Protocol for Outpatient BodyLift Surgery

Nuveen

Matthesen²,

Cox

et al. 2020

Am J Cosmet Surg

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The concept of enhanced recovery after surgery (ERAS) was developed in 2001 in order to create a multimodal, scientifically based approach to the development and audit of protocols for improving outcomes after surgical procedures. These protocols undergo constant evolution and evaluation toward the goal of quality of recovery. The BodyLift (BL) is the procedure that most comprehensively addresses the cosmetic needs of patients after massive weight loss (MWL). In the course of performing 136 consecutive outpatient BL surgeries over 7 years, we have developed a management protocol that has provided consistently high patient satisfaction, minimized frequent complications, and has documented 100% safety in all cases performed without deep vein thrombosis (DVT), transfusion and with 1 postoperative hospital admission. Each evidence-based component in the protocol was instituted to reduce risk of complications known to be most commonly associated with circumferential body contouring surgery. ERAS protocols are now widely used in many other surgical subspecialties. These protocols have the common goal of returning the patient to normal function as expeditiously as possible and are associated with decreased complications as well as shorter length-of-stay (LOS) and reduced costs. We have enumerated the many components of our protocol and aligned each with elements of an ERAS paradigm. In our retrospective review of 7 years of BL surgery (n = 136), this protocol has reduced both major and minor complications to previously unpublished levels. Our independently formulated ERAS protocol for outpatient BL surgery aligns closely with the ERAS concept, limiting surgical stress, thus reducing complications and affording a smooth and predictable perioperative experience. This is of importance for elective cosmetic surgery patients, who often have high expectations for an uneventful recovery and are unaccepting of potentially out-of-pocket costs associated with complications.

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“…Bilateral Oblique Flankplasty was first applied to successfully avoid problems inherent with the male lower body lift (LBL). The standard LBL updated by Lockwood [1] has a complication rate approaching 50% and not only fails to deflate and tightened the flanks but was bedeviled by deep lateral gluteal depressions, elongation of the intergluteal cleft, recurrent saddlebags and flattening of the buttocks [2]. Effective Flankplasty requires deep and wide resection of flank skin and fat to lumbodorsal fascia and External Oblique muscle to reverse lower back skin laxity and bulges and suspends the lateral buttocks and upper thighs.…”

mentioning

confidence: 99%