Analysis of the Strength of the Abdominal Fascia in Different Sutures Used in Abdominoplasties

Ishida, Luís Henrique; Gemperli, Rolf; Longo, Marco Vinicius Losso; Alves, Helio; Silva, Pedro Henrique Quintino da; Ishida, Luis C.; Ferreira, Marcus Castro

doi:10.1007/s00266-010-9578-7

Cited by 15 publications

(3 citation statements)

References 11 publications

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“…22 Others have also suggested plication techniques that address the need for vertical shortening of the aponeurosis using horizontal plications, 23 suggesting that the reliability of such a plication vector is enhanced due to the subtler direction of the aponeurosis of the external oblique. 24 Other techniques that provide vertical and horizontal shortening while better dispersing the tension on sutures include the running horizontal mattress technique 25 and the triangular mattress suture. 26 Scarpa's lift and externus belt maneuver represent two additional techniques to tighten and reshape the abdominal wall and adjacent areas.…”

Section: Biplanar Lipoabdominoplasty With Slas Flap Tighteningmentioning

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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Section: Biplanar Lipoabdominoplasty With Slas Flap Tighteningmentioning

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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“…16 Ishida et al in a cadaveric study compared the strength of a horizontal versus vertical suture repair using a dynamometer. 30 The strength required for disrupting the vertical repair was increased relative to the horizontal, thus vertical orientation was recommended.…”

Section: Outcomes Sheath Plicationmentioning

confidence: 99%

Management Strategies for Diastasis Recti

Nahabedian¹

2018

Seminars in Plastic Surgery

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Diastasis recti is a relatively common condition in which there is a midline abdominal bulge that can affect a variety of individuals. The etiology and diagnosis is well understood and optimal management depends on the degree of severity. Patients at high risk for diastasis recti include multiparous women, obese patients, and those with multiple previous operations. Diagnosis includes clinical examination and assessment of symptoms. Physical characteristics include a midline abdominal bulge without a fascial defect. Classification systems are based on the degree of separation between the paired midline rectus and myofascial deformity. Optimal management varies and includes simple plication of the midline defect, extensive plication of the anterior abdominal wall, and sometimes the use of resorbable or nonresorbable mesh.

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“…Even a small deviation of the line of action can have a significant impact on the how effectively muscles function [20]. A looped 1 PDS is used as a continuous running horizontal mattress suture to imbricate the anterior fascia, which is the most effective suture technique [21]. This facilitates securing the anterior fascia just lateral to the junction of the linea alba and anterior rectus sheath where it is strongest [22].…”

Section: Introductionmentioning

confidence: 99%