Modified Lipoabdominoplasty: Updating Concepts

Ribeiro, Ricardo Cavalcanti; Matos, Wilson Novaes; Cruz, Pedro Felipe Suárez

doi:10.1097/prs.0000000000002321

Cited by 15 publications

(4 citation statements)

References 19 publications

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“…Low placement of the scar and correct positioning of the umbilicus are crucial points in results. 8,47,48 These characteristics were evaluated, and good scores were obtained (1.64 and 1.58 of 2).…”

Section: Discussionmentioning

confidence: 99%

TULUA Lipoabdominoplasty: Transversal Aponeurotic Plication, No Undermining, and Unrestricted Liposuction. A Multicenter Study of 845 Cases

Villegas-Alzate¹,

Blugerman²,

Vera-Cucchiaro³

et al. 2021

Plastic &Amp; Reconstructive Surgery

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Background: TULUA (transverse plication, no undermining, full liposuction, neoumbilicoplasty, and low transverse abdominal scar) is the acronym for a radically different lipoabdominoplasty, intended to add simplicity, improve vascular safety, and attain good results. Modifications are unrestricted liposuction, no flap detachment, massive transverse infraumbilical plication, umbilicus amputation, neoumbilicoplasty, diminished tension wound closure, and low transverse scar settlement. The objectives of this article are to describe the technique and analyze a multicenter experience. Methods: Sixty-eight plastic surgeons from 10 countries provided data for a retrospective review of 845 patients. Aesthetic results were scored by each surgeon using the Salles scale and analyzed in combination with complications to identify associations between patient and surgery characteristics. Results: Of the patients, 95.5 percent were female, 19.7 percent were obese, 35.6 percent had prior scars, 10.4 percent had undergone previous abdominoplasty, 6.5 percent were postbariatric, and 6.6 percent were smokers. One patient had a kidney transplant, and 16.5 percent had comorbidities. Surgery characteristics varied widely, being on average as follows: lipoaspirate, 2967 ml; resection, 1388 g; and surgical time, 3.9 hours; 46.5 percent were not hospitalized. Averaged results were 8.68 of 10 points, besides adequate positioning and proportion of scar and umbilicus, without epigastric compensatory bulging (4.97 of 6 points). Overall complications were 16.2 percent, mostly seroma (8.8 percent); vascular-related complications (i.e., necrosis, wound dehiscence, and infection) constituted 2.7 percent. There were no fatalities. The logistic regression model demonstrated that smoking and obesity duplicate the risk of complications; if age older than 60 years is added, the risk of complication increases seven to nine times. Reported indications were multiple; however, pathologic diastasis was excluded. Conclusion: TULUA lipoabdominoplasty is a new reproducible procedure with good quantified results and an acceptable complication rate.

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Section: Discussionmentioning

confidence: 99%

TULUA Lipoabdominoplasty: Transversal Aponeurotic Plication, No Undermining, and Unrestricted Liposuction. A Multicenter Study of 845 Cases

Villegas-Alzate¹,

Blugerman²,

Vera-Cucchiaro³

et al. 2021

Plastic &Amp; Reconstructive Surgery

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“…12 Conversely, others disputed the role of Scarpa's fascia in helping reduce seroma rates. 13 Previous assessment of the exact lymphatic role of Scarpa's fascia and the subscarpal fat compartment also proved controversial. A cadaver study found that the long subdermal lymphatic drainers coursing inferiorly just deepen and pierce Scarpa's fascia at a level only a few centimeters above the inguinal ligament, thus stating that preservation of Scarpa's fascia is not efficient in boosting postoperative lymphatic drainage.…”

Section: The Subscarpal Lipo Aponeurotic Systemmentioning

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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“…Insbesondere in den 90er Jahren gab es eine Reihe von Veröffentlichungen, welche im Ergebnis von einer ausgedehnten Unterminierung des gesamten Bauches bei Liposuktion während einer Abdominoplastik aufgrund einer erhöhten Komplikationsrate abrieten 23 , 24 , 25 . Nach Entwicklung eines sicheren Verfahrens der Lipoabdominoplastik sank die Komplikationsrate und ist heute nahezu ähnlich der traditionellen Bauchdeckenstraffung 26 , 27 . Zunehmend wird sogar die Lipoabdominoplastik mit zirkumferentieller Liposuktion zum Standard und wird als komplikationsarmes Verfahren weltweit regelmäßig angewendet 28 .…”

Section: Diskussionunclassified

Lipoabdominoplastik in der postbariatrischen Chirurgie: eine relevante Alternative zur Fleur-de-Lis-Abdominoplastik?

Motamedi

Almeida

Allert

2022

Handchir Mikrochir Plast Chir

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Zusammenfassung Hintergrund Die Anzahl an bariatrischen Operationen und somit auch die Anzahl an postbariatrischen Eingriffen ist in den letzten Jahren dramatisch gestiegen. Obwohl in der postbariatrischen Chirurgie lange Narbenverläufe zu Gunsten einer Körperformrekonstruktion üblich sind, beobachten wir neben dem Wunsch der Körperkonturierung zunehmend den nach ästhetisch ansprechenderen Ergebnissen. Insbesondere die Fleur-de-Lis-Abdominoplastik wird aufgrund der sichtbaren vertikalen Narbe von jungen Patientinnen nach massivem Gewichtsverlust kritisch gesehen. Häufig stören sich auch Operateure sowohl am ästhetischen Outcome wie auch an der höheren Komplikationsrate. Methoden Retrospektive Analyse von 20 Patientinnen nach massivem Gewichtsverlust nach bariatrischer Operation, die im Zeitraum von Januar 2020 bis Januar 2021 statt einer Fleur-de-Lis Abdominoplastik eine Lipoabdominoplastik erhalten haben. Die Datenanalyse erfolgte anhand des präoperativen vertikalen und horizontalen Hautüberschüsse (Pittsburgh Rating Scale), anhand des Body-Mass-Index, der operativen Technik und des Endresultats. Ergebnisse 20 Patientinnen mit einer Indikation zur Durchführung einer FdL-Abdominoplastik unterzogen sich einer kombinierten radikalen Liposuktion des Bauches mit traditioneller Abdominoplastik. Das Ursprungsgewicht vor der massiven Gewichtsreduktion rangierte zwischen 100–168 kg. Die durchschnittliche Gewichtsreduktion lag bei 56,5 kg. Im Mittel betrug der BMI 27,3 kg/m². Das Durchschnittsalter unserer Studiengruppe betrug 40 Jahre. Bei einer Patientin (5 %) konnte eine Major-Komplikation verzeichnet werden. Es handelte sich um ein infiziertes Serom, welches konservativ behandelt werden konnte. Eine Patientin (5 %) wünschte eine Nachstraffung in FDL-Technik im weiteren Verlauf. Fazit Die Durchführung einer Lipoabdominoplastik ist auch bei postbariatrischen Patienten gut und sicher durchführbar. Es zeigen sich gute Körperkonturierungen ohne vertikale Schnittführung mit einem hohen Maß an Patientenzufriedenheit. Die Anzahl an Patienten, die sich einer FdL-Abdominoplastik unterziehen müssten, kann mit dieser Technik erfolgreich gesenkt werden.

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Modified Lipoabdominoplasty: Updating Concepts

Abstract: Therapeutic, IV.

Cited by 15 publications

References 19 publications

TULUA Lipoabdominoplasty: Transversal Aponeurotic Plication, No Undermining, and Unrestricted Liposuction. A Multicenter Study of 845 Cases

TULUA Lipoabdominoplasty: Transversal Aponeurotic Plication, No Undermining, and Unrestricted Liposuction. A Multicenter Study of 845 Cases

Biplanar Lipoabdominoplasty: Introducing the Subscarpal Lipo Aponeurotic System

Lipoabdominoplastik in der postbariatrischen Chirurgie: eine relevante Alternative zur Fleur-de-Lis-Abdominoplastik?

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