Re-evaluation of superficial fascia of anterior abdominal wall: a computed tomographic study

Chopra, Jyoti; Raghavan, Anita; Archana, R; Srivastava, Ajay; Sharma, Pradeep K.

doi:10.1007/s00276-011-0801-2

Cited by 32 publications

(15 citation statements)

References 13 publications

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“…[21][22][23][24][25][26][27][28][29][30][31][32] There is considerable scientific data to validate this concept. [21][22][23]28,[32][33][34] We can speak of a trilaminar structure with superficial compartment dominance and a minor contribution of the deep fat compartment to the total thickness (less than 25%).…”

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confidence: 91%

Abdominoplasty With Scarpa Fascia Preservation

Costa‐Ferreira

Rebelo

Vásconez

et al. 2016

Annals of Plastic Surgery

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The plane of dissection used during a full abdominoplasty has been implicated on the seroma rate. Avoiding the classic plane of dissection on top of the rectus fascia and using a more superficial plane of dissection has been suggested as a strategy to improve recovery and lower the complication rate. The authors have been applying this principle in their practice for more than a decade, and they performed 2 prospective comparative studies to evaluate the clinical effects of using a more superficial plane of dissection (with Scarpa fascia preservation) during a full abdominoplasty.The technique is presented and explained along with the results of both comparative studies.The results of both studies are discussed particularly the effects on drain volume (total and daily), the duration of drain usage and the avoidance of "long drainers." These are very relevant advantages of the technique that have not been discussed in the literature. The results and surgical strategies used by other authors which apply a more superficial plane of dissection are presented.Controversy still exits on the manipulation of the deep fat compartment by liposuction or direct fat excision. No manipulation is another option which should be considered but it has been questioned due to the risk of aesthetic compromise. A morphometric study performed on the surgical specimens of 41 female patients submitted to a full abdominoplasty validates that option.Based on this evidence, the authors recommend that surgeons consider performing abdominoplasties using a more superficial plane of dissection in the infraumbilical area with total preservation of Scarpa fascia and the deep fat compartment. The classic plane of dissection, on top of the deep fascia, should be avoided in the lower abdomen.

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confidence: 91%

Abdominoplasty With Scarpa Fascia Preservation

Costa‐Ferreira

Rebelo

Vásconez

et al. 2016

Annals of Plastic Surgery

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“…2 General agreement has now been reached on the existence of a horizontal, membranous layer (the stratum membranosum) of the SFS that lies in between the superficial adipose layer and the deep adipose layer of the subcutaneous tissues between dermis and the deep muscle fascias in most parts of the body. [3][4][5][6][7][8] The SMAS is a continuous fibromuscular layer consisting of collagen fibers, elastic fibers, fat cells, and muscle cells, which overlies the midface and parotic glands and extends cranially as parts of the orbicularis oculi muscles, the superficial temporoparietal fascia and galea and caudally as the platysma. 1,[8][9][10] It is generally accepted to represent the stratum membranosum of the SFS in the head and neck region.…”

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confidence: 99%

“…[1][2][3][4][5][6][7][8][9][10] The SFS is a connective tissue network that extends from the subdermal plan to the underlying muscle fascia. It primarily consists of one to several thin, horizontal membranous sheets separated by varying amounts of fat with interconnecting vertical or oblique fibrous septae.…”

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confidence: 99%

Andreas Vesalius' 500th Anniversary

Brinkman

Hage²

2016

Annals of Plastic Surgery

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Because of their relevance for liposuction and rhytidectomies, respectively, the superficial fascial system (SFS) and superficial musculoaponeurotic system (SMAS) have been thoroughly studied over the past decennia. Although it is well known that the SMAS concept was introduced by Tessier in 1974, it remains unknown who first properly described the stratum membranosum of the SFS. In light of the 500th birthday of Andreas Vesalius (1515-1564), we searched his 1543 masterwork De Humani Corporis Fabrica Libri Septem and related work for references to these structures. We found ample reference to both structures as the membrana carnosa (or fleshy membrane) in his works and concluded that Vesalius recognized the extension, nature, and functions of the stratum membranosum of the SFS, as well as its more musculous differentiation as the SMAS in the head and neck area, and the dartos in the perineogenital area. In doing so, Vesalius recorded most details of the SFS and SMAS concepts avant la lettre.

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“…Due to the presence of the breast, subcutaneous fascia is described that serves as an anchor for the fibrous bands called the breast suppressor ligaments. However, in the supraumbilical thoracoabdominal region lies deep fascia that is muscular . The new international anatomical terminology was updated in 1998.…”

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confidence: 99%

“…However, in the supraumbilical thoracoabdominal region lies deep fascia that is muscular. [10][11][12] The new international anatomical terminology was updated in 1998. Thus, as clearly stated in the anatomical terminology, item A04.0.00.031 clarifies the "fascia" definition.…”

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confidence: 99%