Extended Abdominoplasty: Applications and a New Classification System for Abdominoplasty

Abstract

Extended abdominoplasty is a safe procedure with highly satisfactory results that should become common practice in plastic surgery. There is a group of patients who are best served by this procedure and a new classification system of the abdominal contour deformities that includes these patients is needed and is proposed by the authors.

Cosmetic Body Lift

“…Previous authors have discussed the value of an extended lipoabdominoplasty for optimal truncal contouring for the non-massive weight loss population 12,14,15 ; however, our approach offers certain refinements that can improve contour while concurrently decreasing operative time. The discontinuous undermining of the trunk and thigh fasciocutaneous flaps facilitates optimal mobility to achieve ideal cosmesis.…”

“…[4][5][6][7][8][9] As such, surgeons are frequently required to excise lateral skin excess (or dog-ears) during a second operation. 10,11 Initially, Hunstad and Repta suggested a singlestage, 270-degree, extended abdominoplasty to contour significant lateral truncal skin laxity and lipodystrophy for the non-massive weight loss population 12 ; this approach addressed a degree of ptosis that a standard abdominoplasty would not manage and a circumferential lower body lift would be too aggressive 13 To supplement the outcomes of an extended abdominoplasty, Shestak 14 and Mejia and Cárdenas Castellanos 15 have separately discussed the value of adding liposuction; they report an equivocal complication profile to Lockwood's high-tension lipoabdominoplasty with optimal lateral flank contouring. Despite the correction of the flank lipodystrophy and skin laxity, these patients still have persistent thigh ptosis and/ or lipodystrophy because the lower extremity symptomatology is not addressed in this approach.…”

The experience performing extended abdominoplasty in massive weight loss patients

“…To minimize complications and hospitalization time, we propose a modified approach to the traditional circumferential torsoplasty, described by Mejia and Cárdenas Castellanos [12] as "extended abdominoplasty" in massive-weight-loss patients.…”

“…[11,12] This technique was first described by Mejia and Cárdenas Castellanos [12] to treat aesthetic deformities of the abdomenin non-bariatric patients and it preserves the median dorsal area from surgical traumas. We extended the indication to the massive weight loss patients.…”

“…Patients were selected after passing the following inclusion criteria: severe abdominal and truncal skin redundancy, circumferential lipodystrophy type VI according to Mejia and Cárdenas Castellanos, [12] unchanged weight during the last year, and age between 30 and 65 years.…”