Facilitated Umbilical Positioning in Abdominoplasty Using the 15/10 Rule and the “Flap Flipping” Technique

Rysin, Roman; Wolf, Yoram

doi:10.1097/gox.0000000000003574

Cited by 4 publications

(7 citation statements)

References 16 publications

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“…30 Position also changes with scars, hernias, and pregnancy in women. 15,30,31 Despite reports that BMI does not influence its location, 26 a lower umbilicus is associated with increasing BMI. 5,32 Position may also be influenced by ethnicity, 17 as well as whether the patient is high waisted or low waisted.…”

Section: Discussionmentioning

confidence: 99%

“…1,18,45 The 15/10 rule and flap flipping technique defining an "expected zone" for umbilical positioning has been suggested, as well as an easy-to-use, intuitive yet precise, and simple guide. 15 Abhyankar et al 46 demonstrated that a 1.6:1 ratio approximating the golden ratio exists between xiphisternum-umbilicus and umbilicus-symphysis pubis; the same ratio exists between umbilicus to anterior superior iliac spine and interanterior superior iliac spine. Different ratios of similar reference measurements were, however, reported in subjects of different ethnicities; African American people have a lower lying umbilicus compared with White people.…”

Section: Discussionmentioning

confidence: 99%

“…3,13,14 Obviously, when judging an abdomen for its attractiveness, umbilicus position and shape cannot be ignored. 6,15 Achieving a desirable result is obtained only by avoiding an undesirable high-or low-riding navel. 16 Numerous techniques have been described for the restoration of the umbilicus in its new position 15 ; there is, however, no universal consensus and standardization regarding ideal position and shape.…”

Section: Introductionmentioning

confidence: 99%

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Determination of Appropriate Umbilicus Position during Abdominoplasty in Male Patients

Atiyeh,

Emsieh,

Ibrahim

et al. 2023

Plastic and Reconstructive Surgery - Global Open

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Background: Abdominoplasty techniques are well documented. The ideal position of the umbilicus has, however, received limited attention. Unfortunately, umbilicus position is not universally agreed upon in male cosmetic abdominoplasty. This study was conducted to determine the ideal umbilicus anthropometric measurements in young men, and the relationships between umbilical position and anterior trunk and torso reference points that may be applicable to intraoperative positioning. It is aimed also at investigating whether umbilicus position would be more accurately determined by considering nipple position instead of the abdominal crease, as recently proposed. Methods: Several anthropometric measurements of various anterior abdominal and thoracic landmarks were conducted on 60 young and middle-aged male volunteers and 30 cadavers at São Paulo city. All statistical analysis was completed using Stata software. Results: Of all the measured reference points, a much stronger correlation (0.513) was demonstrated between umbilicus-anterior axillary fold (U-AX) and inter-nipple (N-N) distances with a constant golden number ratio relationship (N-N = U-AX × 0.618) compared with the weak correlation of 0.034 between umbilicus-xiphisternum and umbilicus-abdominal crease. In 75% of volunteers, the calculated U-AX was within ±3 cm of actual measurement, and in 33.33% within ±1 cm. Conclusions: U-AX = 1.618 × N-N equation is more predictive of adequate umbilicus repositioning during abdominoplasty in male patients. Chest and abdomen of men are a single aesthetic unit. Proper positioning of the nipples and umbilicus, as well as harmonious abdominal and torso proportions are critical for an optimal final aesthetic outcome.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Determination of Appropriate Umbilicus Position during Abdominoplasty in Male Patients

Atiyeh,

Emsieh,

Ibrahim

et al. 2023

Plastic and Reconstructive Surgery - Global Open

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“…The umbilicus was exteriorized through a vertical incision through the superior flap drawn along the midline. 9 The flap was then anchored to the mons pubis, and to the scarpal cuff cephalade with three Vicryl 0 single sutures. Skin was approximated in two layers, Vicryl 2/0 spiral continuous sutures for the superficial fascia and and Vicryl 3\0 spiral continuous intra-dermal-sutures, finalized by biological glue, dressed and snugged in an abdominal binder.…”

Section: Takeawaysmentioning

confidence: 99%

Biplanar Lipoabdominoplasty: Introducing the Subscarpal Lipo Aponeurotic System

Wolf

Weissman²,

Dima

et al. 2022

Plastic and Reconstructive Surgery - Global Open

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Background: Preservation of Scarpa's fascia in abdominoplasty has been previously presented. Herein we introduce the subscarpal lipo aponeurotic system (SLAS) and the technique of preserving the SLAS and its tightening in lipoabdominoplasty. Methods: A retrospective cohort study of patients who underwent lipoabdominoplasty performed by a single plastic surgeon (YW) between 2014 and 2019 was conducted. We compared postoperative complications, aesthetic outcomes, and procedure lengths between standard and biplanar lipoabdominoplasty with SLAS tightening. Supra-scarpal fat and SLAS tissue specimens were obtained for histological analysis. Results: In total, 179 patients underwent biplanar lipoabdominoplasty with SLAS tightening and were compared with a control group of 65 patients who underwent standard lipoabdominoplasty. Fifty-four patients (29.9%) underwent concomitant umbilical, epigastric, or postoperative ventral hernia (POVH) repair. No major complications were encountered other than one skin necrosis in a standard lipoabdominoplasty. Moderate complication rate was 10.05% in the biplanar group, compared with 16.92% in the standard lipoabdominoplasty. The average length of the procedure and overall aesthetic results were equivalent. Conclusions: The SLAS can be individually dissected and used during abdominoplasty. No statistically significant differences were found in complication rates, length of procedure, or aesthetic outcomes between standard and biplanar lipoabdominoplasty with SLAS tightening. Further investigation is needed. Nonetheless, we postulate that patients who would benefit the most from this procedure are those with weakening of the abdominal wall, and with some fullness of the hip line, as this technique adds reinforcement to the lower abdomen and "pulls in" the flanks.

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“… 1 Classically, the umbilicus is transposed up to 3 cm above the iliac crest, but recent studies have challenged this concept, with the umbilicus being transposed based on the 15/10 measurement of the patients’ torso. 2 Unfortunately, not all torsos are equal, making consistency difficult. In a 2016 study, Viconti and Sagarello used the Fibonacci caliper to calculate the golden ratio (1.618) from xiphoid to abdominal scar for proper umbilical placement.…”

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confidence: 99%