![]() ![]() In a similar manner, fibrin glue has also been proposed for collapsing the space below the abdominal flap (Level of Evidence: Therapeutic, III ). In 2012, Pollock and Pollock published their experience with 597 patients, in whom progressive tension sutures were used for this purpose, reporting only 1 case of seroma in 12 years (Level of Evidence: Therapeutic, IV). Baroudi and Ferreira, two of this technique’s most renowned advocates, have argued that collapsing this space reduces the possibility of liquid accumulation. published a prospective randomized study comparing scalpel and handheld electrocautery dissection, finding no difference in the seroma rate between the 2 groups (Level of Evidence: Therapeutic, II).Īnother proposed alternative is to use sutures to obliterate the dead space between the Scarpa fascia and the rectus abdominis and external oblique muscle fascia. ![]() Swanson argued that a seroma rate of 5.4% can be achieved with scalpel dissection below the Scarpa fascia (Level of Evidence: Therapeutic, V). However, some authors have expressed scepticism regarding the impact of a more superficial dissection, especially because of the lack of blinding in the previously discussed studies. and Fang, this technique would allow earlier drain removal while avoiding up to 86% of expected seromas (Level of Evidence: Therapeutic, II). According to studies by Costa-Ferreira et al. One of them is the preservation of the Scarpa fascia while raising the abdominal flap, leaving it attached to the rectus abdominis and external oblique muscle fascia. Unfortunately, no consensus exists regarding the definition of a clinically significant seroma or an objective method of assessing this outcome.ĭifferent surgical strategies have been proposed to reduce the risk of seroma formation. These percentages are far greater than the 0.04% seroma rate reported by Hurvitz et al. published a series of 200 patients, showing that the seroma rates in the abdominoplasty and lipoabdominoplasty groups were 16% and 31.2%, respectively. The possibility of a higher incidence of seroma in lipoabdominoplasties than in abdominoplasties without liposuction remains controversial. In this study, the authors identified an association between adjuvant liposuction and a higher risk of suffering a seroma, particularly in male patients. in 2013, the reported seroma rate was 15.4%. In the series of 1,008 cases published by Neaman et al. The accumulation of serous fluid underneath the abdominal flap is the most frequent complication following an abdominoplasty. This has a special relevance for aesthetic procedures, because these are generally elective procedures undergone by healthy patients whose expectations can be ruined by a subsequent complication. The systemic complication rate was less than 0.1% for all techniques.Įvery complication poses a challenge for the plastic surgeon and puts the patient-doctor relationship at risk. The local complication rates were 20%, 10.3%, and 13.5%, respectively. The analysis comprised 20,029 procedures, of which 55% were traditional abdominoplasties, 35% were lipoabdominoplasties, and 10% were limited abdominoplasties, also known as mini-abdominoplasties. surveyed 497 members of the American Society of Plastic Surgeons about their preferences regarding different abdominoplasty techniques and their most frequent complications. The combination of abdominoplasty and liposuction is usually referred to as lipoabdominoplasty.Īs is the case for any other surgical intervention, both abdominoplasties and lipoabdominoplasties are susceptible to complications. A safe approach involves raising a narrow tunnel from the umbilicus up to the xyphoid process, preserving the lateral perforating vessels. Despite the initial concerns regarding a higher risk of flap necrosis with this technique, since the publication of the studies by Saldanha et al. Performing adjuvant liposuction of the abdominal wall as is a more recent proposal that has led to higher satisfaction rates in select groups of patients. ![]() The contemporary techniques that have subsequently been described share 3 characteristics: limited dissection of the abdominal flap, plication of the rectus abdominis fascia, and resection of a segment of skin and underlying subdermal tissue down to the Scarpa fascia. However, it was during the 1960s and 1970s that the contributions of Vernon, Pitanguy, and Grazer established the founding pillars of modern abdominoplasty. Since its initial conception more than a century ago, various surgical alternatives have been proposed. The main objective of an abdominoplasty is to reshape the body contour by means of excising redundant skin and fat tissue to remodel the abdominal wall. It is estimated that more than 800,000 people undergo this operation each year, making it the sixth most common cosmetic procedure. The abdominoplasty is one of the most commonly performed aesthetic surgical procedures across the world. ![]()
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