Abdominoplasty in patients with previous abdominal surgery

Abstract

Abdominoplasty is a common procedure within plastic surgery; it aims to reshape the abdominal wall by combining skin and subcutaneous tissue resection with musculoaponeurotic reinforcement. The presence of infraumbilical scar don't present a problem as it will be excised with the excess ellipse, but supraumbilical (vertical, oblique or transverse) scars must always be considered in patients for whom an abdominoplasty is planned, and various techniques are described to treat these cases.

Limited abdominoplasty of the low transverse type with limited undermining only up to the level of the umbilicus is performed in order not to compromise blood supply in the zone between the old transverse and the new transverse scar.

Limited undermined of the flap in an inverted-V fashion, preserving the intercostals blood supply and elevating the flap only to the degree necessary to achieve wound closure without tension and repair of the diastasis. Discontinuous undermining by dissecting the supraumbilical flap by blunt dissection is described to improve flap perfusion. Progressive tension sutures or Quilting sutures better to performed when there is large dead space or at high risk patients.

Liposuction is performed away from the zones 1 and 3 of Huger, but liposuction of the hip and lower flanks is performed freely. It is preferably to perform a second-stage liposuction.