Outcome Analysis of Combined Lipoabdominoplasty versus Conventional Abdominoplasty

Heller, J; Teng, Edward; Knoll, Bianca; Persing, John A.

doi:10.1097/prs.0b013e31816b1350

Cited by 87 publications

(47 citation statements)

References 23 publications

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“…Although it is generally accepted that some form of seroma prevention is needed in abdominoplasty, the "best" technique is highly debatable. The suggested techniques for seroma reduction, in addition to PTS, are numerous and include limiting dissection, 7,23,24 dissecting above the superficial fascia to avoid disruption of lymphatics, 8 avoiding or limiting liposuction in conjunction with abdominoplasty, extending maintenance of the hipflexed posture, postoperative immobilization, compression, use of plaster casts and weights, 25 and use of fibrin glues and drains. The etiology of seroma in general and in regard to body contouring remains uncertain but is likely multifactorial.…”

Section: Discussionmentioning

confidence: 99%

“…In other studies, the frequency of seroma has been highly variable. 3,4 In the plastic surgery literature, many theories have been proposed concerning the etiology of seroma as a complication of abdominoplasty; these include concomitant liposuction, [5][6][7] dead space due to extensive dissection, disruption of abdominal lymphatics, [8][9][10] and postoperative movement by the patient. [11][12][13] Although the etiology of seroma formation in abdominoplasty has not been determined, the low incidence of seroma when the flap is affixed securely to the deep fascia with progressive tension sutures (PTS) suggests that flap motion may play a significant role.…”

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confidence: 99%

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Progressive Tension Sutures in Abdominoplasty: A Review of 597 Consecutive Cases

Pollock

2012

Aesthetic Surgery Journal

121

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Background: Although abdominoplasty and other body-contouring procedures are being performed more frequently, the incidence of seroma and other complications has remained relatively unchanged. In 2000, a small retrospective series introduced progressive tension sutures (PTS) in abdominoplasty to reduce seroma without the use of drains. Objectives: The authors review the PTS technique and their experience with the procedure. Methods: A retrospective chart review of 597 consecutive abdominoplasty patients treated over 12 years was performed. Collected data included surgical setting, concomitant procedures, and complications. Results: Of the 597 abdominoplasties, 52.4% were performed in the hospital and 47.6% in an American Association for Accreditation of Ambulatory Surgery Facilities (AAAASF)-accredited facility. In 63.7% of cases, abdominoplasty was combined with another procedure(s). Liposuction was performed on the abdominoplasty flap or an adjacent area to the abdominoplasty dissection in 67% of patients. The average amount fat aspirate from these areas was 953 mL. No drains were placed. The rate of local complications was 4.2%; all but one of these complications (seroma; 0.1%) were minor. There were no systemic complications related to PTS and no venous thromboembolisms. Conclusions: PTS are an adjunct to abdominoplasty that can minimize seroma and potentially decrease other local complications. They provide secure fixation of the flap to eliminate motion and broadly transfer tension to the superficial fascial system. Drains can safely be eliminated from abdominoplasty, even when liposuction is performed. Systemic complications may be avoided and patient recovery expedited.

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Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

Progressive Tension Sutures in Abdominoplasty: A Review of 597 Consecutive Cases

Pollock

2012

Aesthetic Surgery Journal

121

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“…levantamentos, sendo de 16% a incidência de TVP e embolia pulmonar, neste último estudo 21 . Em 2008, Heller et al 22 concluíram que a lipoabdominoplastia, com dissecção supraumbilical mediana limitada, produziu menor número de complicações do que a abdominoplastia tradicional. Atribuíram ao fato de reduzir a tensão na linha média de sutura e grande preservação do fluxo vascular para o retalho vindo das artérias intercostais.…”

Section: Discussionunclassified

Lipoabdominoplastia ampliada associada a múltiplos procedimentos cirúrgicos

Oliveira¹

2011

Rev. Bras. Cir. Plást. (Impr.)

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Lipoabdominoplastia ampliada associada a múltiplos procedimentos cirúrgicosAmplified lipoabdominoplasty associated with multiple surgical procedures RESUMO Introdução: A lipoabdominoplastia tem se mostrado uma técnica segura, com obtenção de bons resultados estéticos, trazendo uma outra visão à abordagem do contorno corporal. Objetivos: Este trabalho demonstra uma experiência pessoal, com a lipoabdominoplastia, descolando de forma ampla as regiões periumbilical e supraumbilical, com base na anatomia vascular da parede abdominal em sua porção lateral. O trabalho também demonstra a associação frequente a múl-tiplos procedimentos cirúrgicos. Método: Foram tratados 138 pacientes, no período de janeiro de 2002 a dezembro de 2009, que tinham indicação tanto para abdominoplastia clássica quanto para a lipoaspiração de abdome simultaneamente. Foram excluídos pacientes com obesidade mórbida e aqueles sem condições clínicas para cirurgia. A cirurgia foi realizada fazendo-se a lipoabdominoplastia com o descolamento do retalho supraumbilical e da região periumbilical, mais ampliado lateralmente, sendo que o retalho infraumbilical não foi lipoaspirado, sendo removido em bloco com a fáscia de Scarpa. Em associação à lipoabdominoplastia foi realizada a lipoaspiração de, no mínimo, três regiões (dorso, flancos e abdome), muita vezes, associada a outros procedimentos de cirurgia plástica ou cirurgias de outras especialidades (50% dos pacientes). Resultados: Todos os procedimentos tiveram resultados considerados satisfatórios pelos pacientes, realizados num tempo médio de 3 horas, com complicações locais pequenas, mas de fácil resolução. Conclusões: A lipoabdominoplastia sem lipoaspiração do retalho infraumbilical e com remoção da fáscia de Scarpa, mesmo sendo feita com um descolamento maior, nas regiões mediana periumbilical e supraumbilical, demonstrou ser uma cirurgia segura, podendo ser associada a outros procedimentos cirúrgicos.Descritores: Abdome/cirurgia. Lipectomia. Cirurgia plástica/métodos. ABSTRACT Introduction:Lipoabdominoplasty has been as a safe showed technique with good aesthetic results, bringing a new view to the approach to the body's contour. Objectives: This study shows a personal experience with lipoabdominoplasty, widely detaching the periumbilical and supraumbilical areas, based on the vascular anatomy of the abdominal wall in its lateral section. The study also shows the frequent association with multiple surgical procedures. Methods: 138 patients were treated during the period from January 2002 to December 2009, who had a recommendation for both classical abdominoplasty and simultaneous liposuction of the abdomen. Patients with morbid obesity or with no clinical conditions for surgery were excluded. Surgery was carried out by doing the lipoabdominoplasty with the detachment of supraumbilical cutting and of the perimbilical area, more amplified laterally, whereas the infraumbilical cutting was not submitted to liposuction, but removed in its entirety together with Scarpa's fascia. In conjunction with the...

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“…Heller et al [20] konnten zeigen, dass kombinierte Lipo-Abdomino-Plastiken mit einer hohen Patientenzufriedenheit und einer geringen Komplikationsrate einhergehen (Evidenzlevel III).…”

Section: Standardabdominoplastikunclassified

Körperstraffungen

Df¹,

Stoff²

2011

Chirurg

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Indications for most forms of abdominoplasty are slight weight fluctuations or pregnancy. The steadily increasing number of patients with greater weight loss as well as the growing number of bariatric operations subsequently leads to a significant increase in body contouring procedures and places new challenges on plastic surgeons. After major weight loss patients present with extremely variable deformities in the lower and upper trunk as well as the extremities, which have to be treated individually with an appropriate procedure. The restoration of the lower trunk presents the first stage of the entire reconstruction process. The various modifications of abdominoplasty procedures with their various incision patterns and scar courses and the circumferential lower trunk dermatolipectomy represent advanced operations for every individual case. Plastic surgeons should be fully aware of differences and indications of every available procedure in the area of the lower trunk and should have the ability to offer the entire repertory for each individual deformity. A high postoperative patient satisfaction results from a customized procedure selection, the optimal implementation with a correspondingly low rate of complications and above-average patient care.

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Outcome Analysis of Combined Lipoabdominoplasty versus Conventional Abdominoplasty

Cited by 87 publications

References 23 publications

Progressive Tension Sutures in Abdominoplasty: A Review of 597 Consecutive Cases

Progressive Tension Sutures in Abdominoplasty: A Review of 597 Consecutive Cases

Lipoabdominoplastia ampliada associada a múltiplos procedimentos cirúrgicos

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