Lipoabdominoplasty without undermining enhances aesthetic results with fewer complications than traditional abdominal aesthetic surgery. Aesthetic Surg J 2001;21:518-526.).

With a progressive adaptation of this technique, it is possible to achieve a harmonious body contour using a safe liposuction method on the abdominal and costal areas, with fast recovery and good to excellent results.

Our objective is to present a new surgical concept for the aesthetic treatment of the abdominal region using the principles of liposuction associated with the traditional abdominoplasty. Lipoabdominoplasty is different from other techniques because it has the advantages of conserving perforator vessels of the abdominal wall, it preserves suprapubic sensibility, results in better abdominal contouring, has a low rate of complications, and a faster recuperation after surgery. The traditional abdominoplasty has been used for many years with several modifications intending to achieve better aesthetic contouring and to reduce complications. However, each modification solves problems only partially. The authors perform the surgery beginning with wet lipoplasty in superficial and deep fat layers. The skin below the umbilical scar is excised as in classical abdominoplasty. After that, selective and safe undermining of the dermocutaneous flap is done in the middle section of the upper abdomen between the borders of the rectus abdominis muscle, preserving mainly supply vessels of the abdominal wall.

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Background: In the past two decades, lipoabdominoplasty has increased in popularity worldwide, presenting low rates of complications and morbidity when the proper surgical steps are followed. The authors present an update of the lipoabdominoplasty technique with the addition of an abdominal definition and standardized steps for its safe execution, an initial personal experience with the procedure that improves the aesthetic results. Methods: Anatomical limits are described for preoperative markings for selective liposuction with abdominal definition. Specific areas of the abdomen are presented to differentiate the areas for an intense or moderate liposuction and the areas for superficial and deep liposuction for anatomical definition. The principles of traditional lipoabdominoplasty are also described and maintained. The initial experiences with 128 patients undergoing the technique are included. Results: One hundred twenty-eight patients were operated on by the senior author (O.S.) from 2016 to 2019 using the described technique. One patient presented with a seroma (0.8 percent), and two had a small skin epitheliolysis (1.5 percent). No other major complications were observed. It is the senior author’s opinion that the obtained aesthetic results from the lipoabdominoplasty with definition are superior to those of the traditional technique, as it enhances the natural contour of the abdomen. Conclusions: Lipoabdominoplasty with anatomical definition has improved the aesthetic results of traditional lipoabdominoplasty without compromising the safety of that technique. More natural results along the abdominal contour that avoid a completely flat abdomen have been observed by most patients. This approach is safe and reproducible, with low complication rates, and it effectively enhances body contour.

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Rev. Bras. Cir. Plást. 2011; 26(2): 275-9 275Lipoabdominoplastia: redução das complicações em cirurgias abdominais Lipoabdominoplastia: redução das complicações em cirurgias abdominais Lipoabdominoplasty: reduction of complications in abdominal surgery RESUMO Introdução: As deformidades estéticas e funcionais do abdome sempre representaram um grande desafio na Cirurgia Plástica. Em busca de soluções para estes problemas, foi desenvolvida a abdominoplastia, que ao longo dos anos vem apresentando modificações e aperfeiçoamentos, buscando melhores resultados estéticos e funcionais, com menores índices de complicações. A lipoabdominoplastia, desenvolvida em 2000 por Saldanha e publicada em 2001, quando esse termo foi utilizado pela primeira vez na literatura mundial, representa uma opção segura para a associação da lipoaspiração à abdominoplastia. A técnica é baseada na preservação dos vasos perfurantes abdominais, ramos das epigástricas profundas superiores e inferiores. Método: Foi comparada a incidência de complicações nas abdominoplastias clássicas e a lipoabdominoplastias realizadas no período de janeiro de 1979 a 30 de junho de 2010, na Clínica Saldanha, em Santos -SP. Discussão: O descolamento seletivo entre as bordas dos músculos reto abdominais, preconizado pela técnica, promove diminuição da área de descolamento do retalho e preserva os vasos perfurantes da parede abdominal, responsáveis por 80% do suprimento sanguíneo da região e, consequentemente, diminui o sangramento e os riscos de hematoma, de isquemia e necrose do retalho. Conclusão: Associando a abdominoplastia com a lipoaspiração e preconizando um descolamento seletivo com preservação dos vasos perfurantes, é possível obter melhores resultados estéticos favoráveis, além de menor morbidade pós-operatória e redução da taxa de revisões cirúrgicas.Descritores: Abdome/cirurgia. Lipectomia. Cirurgia plástica/métodos. ABSTRACT Introduction:The cosmetic and functional deformities of the abdomen always represented a great challenge for plastic surgery. In search of solutions to these problems, we developed the abdominoplasty, which over the years has had modifications and improvements, looking for better cosmetic and functional results, with lower complication rates. Lipoabdominoplasty was developed in 2000 by Saldanha and published in 2001, when that term was first used in the literature, and represents a safe option for the combination of liposuction and abdominoplasty. The technique is based on the preservation of abdominal perforating vessels, branches of the superior and inferior epigastric deep artery. Methods: We compared the incidence of complications between the classic abdominoplasty and lipoabdominoplasty carried out from January 1979 to June 30, 2010, at Saldanha's Clinic, in Santos -SP. Discussion: The selective displacement between the edges of the rectus abdominis muscles, as advocated by technique, promotes a decrease in the area of detachment of the flap and preserves the abdominal wall perforator vessels account for 80% of the blood supply...

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