Abdominoplasty with Scarpa s Fascia Advancement Flap to Enhance the Waistline

Size: px
Start display at page:

Download "Abdominoplasty with Scarpa s Fascia Advancement Flap to Enhance the Waistline"

Transcription

1 My Way Abdominoplasty with Scarpa s Fascia Advancement Flap to Enhance the Waistline Aesthetic Surgery Journal 2016, Vol 36(7) The American Society for Aesthetic Plastic Surgery, Inc. Reprints and permission: journals.permissions@oup.com DOI: /asj/sjv254 David Whiteman, MD; and Gabriele C. Miotto, MD Accepted for publication November 19, 2015; online publish-ahead-of-print March 15, Abdominoplasty for body contouring has evolved from focusing primarily on modification of the skin flap and underlying rectus diastasis repair, to the association of liposuction and limited undermining techniques. While plication of the midline diastasis reliably improves anterior posterior dimensions, it has a more limited effect on the waist contour. Nahas suggested that increasing the width of the plication of the anterior rectus sheath may be responsible for displacement of the contours of the abdomen, yielding unnatural results. 1 In an attempt to achieve reliable waist modification, different techniques have been published. L-shaped external oblique muscle plication, multidirectional abdominal wall plication, and advancement of the external oblique muscle flaps have been described. 2 Plication of the external obliques demonstrates limited mobility and the creation of widely undermined external oblique flaps is typically beyond the scope of the standard outpatient procedure. It has been suggested that the preservation of Scarpa s fascia during abdominoplasty may lead to a decrease in postoperative complications. 3,4 Friedman et al suggested that up to 17% of the lymphatic drainage of the abdominal wall is maintained if dissection is performed above Scarpa s fascia. 5 The use of Scarpa s fascia to enhance the waist line definition during abdominoplasty has been limited. Mossaad et al used a medial directional pull on Scarpa s fascia in an effort to define the waistline as a modification of the lipoabdominoplasty technique described by Saldanha et al. 6-9 Mossaad s technique removes a full thickness midline strip of subcutaneous tissue below the umbilicus down to the rectus sheath, extending approximately 4 cm lateral to the midline on each side. Tissue advancement was achieved only through lipo-mobilization using standard liposuction techniques with o undermining above the umbilicus other than the midline. Mallucci presented a refinement to traditional abdominoplasty using a superficial fascial glide technique. In this technique, a full thickness abdominoplasty flap is elevated. 10 During the excision of skin excess, a flap of superficial fascia 3 cm distal to the skin is created and pulled in an oblique direction towards the midline while the abdominal skin is pulled downward. This is not a technique in which there is maintenance of the continuity of Scarpa s fascia lymphatic system. This paper presents the use of bilateral infero-medially directed Scarpa s fascia advancement flaps as an adjunct to waistline definition during traditional abdominoplasty, miniabdominoplasties, as well as the Saldanha lipoabdominoplasty technique. The Scarpa s fascia advancement flaps can be easily performed and supplements the effect of liposuction in the waistline. It also modifies the waistline in the thin patient where liposuction is not indicated. Since the description of the superficial fascial system of the upper trunk by Lockwood it is known that interconnecting fibrous septa run from the dermal layer in multiple directions to the Scarpa s fascia. 11 Those strong interconnections allow for pulling forces to be translated to the skin when tension is placed on the fascia flaps, even after liposuction. The Scarpa s fascia flaps work in a similar way in which the SMAS flaps in facelifts can be used to carry the skin flap. As in the facelift, the fascia and the skin do not have to move in the same vector and can be modified for different aesthetic goals. In both cases, the flaps are substantial and can bear tension. Dr Whiteman is the Chairman of Surgical Services, Gwinnett Medical Center, Duluth, GA. Dr Miotto is an Intern, Department of Surgery, Emory University School of Medicine, Atlanta, GA. Corresponding Author: Dr Gabriele C. Miotto, 1065 Peachtree Street Northeast, #3705, Atlanta, GA 30309, USA. gabrielemiotto@hotmail.com

2 Whiteman and Miotto 853 Figure 1. This illustration shows the plane of the abdominal flap dissection above the Scarpa s fascia in the area below the umbilicus. TECHNICAL DETAILS Preoperative consultations were used to focus on patient goals. All patients seeking waist narrowing or waist modification were considered candidates for the use of the Scarpa s fascia flaps. Patients were examined for the degree to which subcutaneous fat was contributing to the fullness above the anterior superior iliac spine and translating posteriorly into the flank. Using a pinch technique, patients with greater than 3 cm of subcutaneous fat were considered candidates for lateral abdominal wall liposuction as well as Scarpa s fascia flap. In those with less than 3 cm of fat, no sub-scarpa s liposuction is performed, only the Scarpa s fascia flap. Attention was then turned to the supraumbilical subcutaneous fat thickness. Patients with fullness in this area underwent the Saldanha s (Brazilian) lipoabdominoplasty. In patients with significant skin laxity, skin ptosis or multiple supraumbilical skin folds, a wide dissection technique above the umbilicus was used instead of lipoabdominoplasty. All patients were marked standing in the preoperative area. A low mildly curved suprapubic abdominal incision and all areas for liposuction were defined. Procedures were completed under general anesthesia with the patient supine on the operating table. When indicated, a tumescent fluid 1:1 was added for standard liposuction of the lateral abdominal wall, flank, and anterior supraumbilical sites. Following the liposuction with three or four millimeters Mercedes cannulas above the Scarpa s fascia, the abdominoplasty proceeded. The incision is carried down to the level of Scarpa s fascia(figure 1), which can be easily identified by its shiny white color. The abdominal flap is elevated above the Scarpa s fascia using electrocautery up to the umbilicus, which is circumscribed. Figure 2. Flap elevation including the central portion of Scarpa s fascia below the umbilicus on a 45-year-old woman. Above the umbilicus, the abdominal flap is undermined below Scarpa s fascia up to the xiphoid process. A limited central tunnel is created with preservation of lateral perforators in individuals requiring extensive liposuction during the Saldanha s lipoabdominoplasty, or a wide undermining is performed when a traditional abdominoplasty is indicated. Below the umbilicus, Scarpa s fasciaflaps are created.the fascia is grasped by two clamps and divided over the linea alba down to the rectus muscle fascia. Then, a 4 to 5 cm wide triangular shaped excision of the midline fascia is performed to avoid overlapping of the inferior border of the flaps when advanced medially. Optionally, we can elevate and excise this central triangular medial portion of the Scarpa s

3 854 Aesthetic Surgery Journal 36(7) Figure 3. (A) Scarpa s fascia flaps are pulled in an infero-medial direction to improve the definition of the waistline. (B-E) Intraoperative photographs of a 54-year-old woman with previous hysterectomy undergoing Scarpa s fascia flap abdominoplasty with wide supraumbilical undermining and two-layer vertical plication of the rectus muscle. No liposuction was performed. (B) The initiation of the procedure with an arrow demonstrating proposed direction of flap advancement. (C, D) Demonstrating the proposed direction of flap advancement to create waist definition. (E) Demonstrating Scarpa s fascia flap advancement with suture of the fascia to the underlying of abdominal wall using a 2-0 Monocryl suture and resultant waistline.

4 Whiteman and Miotto 855 fascia at the time of initial flap elevation, preserving the lateral flaps for advancement (Figure 2). Shaping the medial flap edges as the sides of a triangle or a J shape avoids a centralized bulk after plication. The triangle can be excised either at the superior or inferior edge of the flap for better contour. The lateral Scarpa s fascia and sub-scarpa s fatty areolar layer are preserved. We do not perform infraumbilical liposuction below the Scarpa s fascia. The plication of the rectus muscle diastasis above and below the umbilicus is performed by a running V-Loc (Covidien, Mansfield, MA), just enough to re-approximate the rectus muscles. After diastasis plication, the Scarpa s fascia flaps are grasped with clamps and pulled in an inferomedial direction while inspecting the skin above the anterior superior iliac spine for waist contour change (Figure 3) (Video 1, available as Supplementary Material at com). Once the appropriate vector is identified, the fascia flaps are sutured under tension to the rectus muscle fascia or to the linea alba with a 2-0 Monocryl depending on the quality of the flaps and degree of advancement needed (Figure 4). With the patient in a 35 back-elevated position, excess skin is removed. The abdominal skin can now be advanced for closure from lateral to medial. Attention to proper suturing is necessary to avoid excessive suprapubic wrinkling. Wound closure is completed in two layers of 2-0 and 3-0 Monocryl suture. Two 7 mm Jackson Pratt drains were used for the first 165 cases and a change from use of drains to use of quilting sutures over the last months is part of the main author s technique evolution. Pain pumps are used upon patient request and were placed entirely within the rectus sheaths. Tegaderm surgical dressings (3 M, St. Paul, MN) and abdominal binder are always applied. Antithrombotic prophylaxis included venous compression hose and intermittent compression device applied preoperatively and intraoperatively. Postoperative prophylaxis included Lovenox (Sanofi, Bridgewater, NJ) 40 mg beginning a.m. postoperative day one and continued for 7 days. Patients were administered preoperative cefazolin 1 g, or clindamycin 600 g IV for penicillin allergic individuals. MY EXPERIENCE This technique has been used in 348 consecutive female patients that underwent abdominal procedures including 217 (62%) traditional abdominoplasties, 108 (31%) lipoabdominoplasties, and 23 (7%) miniabdominoplasties. The mean age of the patients was 42 years (range, years), the mean body mass index (BMI) was 29 kg/m 2 (range, kg/m 2 ), and the average associated volume of liposuction of the abdominal wall was 468 cc (range, cc). The patient population consisted of 174 (50%) Caucasian, 120 (34%) African American, 50 (14%) Hispanic, 2 (0.3%) Asian, and 2 (0.3%) Middle Eastern patients. Figure 4. This illustration shows the shape and the vector of ideal mobilization of the Scarpa s fascia flaps once the flaps are sutured in place. This technique can be performed in patients of all body habitus. The versatility exists as long as the infraumbilical elevation of the abdominal flap is completed above Scarpa s fascia. The plane of dissection above the umbilicus is deep to Scarpa s fascia to address the need for diastasis plication. In patients with a BMI above 30, the results may not be as profound due to a lack of mobility of the fascial flaps. It seems that the greatest indication for the use of the Scarpa s fascia flaps is in the thin patient that does not require liposuction at all. In these patients, the effect of flap advancement through the connections between fascia and skin is easily visible and highly defines the waistline. OUTCOMES This technique has been used successfully in 348 consecutive female patients. Figure 5 shows a typical postoperative result of the use of the Scarpa s fascia flap at 14 months after surgery, with good definition of the waistline. Supplementary Figure 1 shows another patient 13 months after surgery. Both patients had mastopexies at the time of the abdominoplasty. Out of the 348 cases, seven (4.2%) patients required scar revision either for dog ears or scar asymmetry. Six (3.6%) patients developed postoperative seromas. Four of the six seromas occurred above the umbilicus in the patients who had wide undermining of the flap. Five of the six seromas occurred in the traditional abdominoplasty group with wide undermining and one in a lipoabdominoplasty patient. This complication seems to have decreased with the use of more extensive quilting sutures in the upper abdomen, eliminating the need for drains. Three of the seromas resolved with

5 856 Aesthetic Surgery Journal 36(7) Figure 5. This 34-year-old woman underwent a traditional abdominoplasty with wide superior undermining, and liposuction of the hip roll and superolateral abdomen with Scarpa s fascia advancement flaps. She also underwent mastopexy with use of superomedial pedicles. (A, C) Preoperative and (B, D) postoperative photographs taken at 14 months. aspiration while the remaining three required placement with placement of a SeromaCath (Greer Medical, Santa Barbara, CA). Five patients (2.9%) required removal of suture material from the wound following development of symptomatic suture granulomas. These patients were in the group in which a running subcuticular barbed suture closure was completed. Four (2.4%) patients experienced minimal wound necrosis that resolved with local care. Four (2.4%) patients underwent steroid injection for scar hypertrophy. Three (1.8%) patients developed superficial wound infection and were treated with oral antibiotics or antibiotic ointment for suspected minor infections characterized by wound redness or drainage. One (0.6%) patient developed a MRSA infection, which required reoperation for drainage and six weeks of intravenous antibiotics. One (0.6%) patient with a history of diabetes had major wound necrosis and required reoperation for debridement with secondary healing. One (0.6%) patient developed a hematoma within three hours of drain removal and required reopening of the wound under local anesthetic. One (0.6%) patient developed a significant

6 Whiteman and Miotto 857 complication secondary to bupivacaine toxicity due to malfunction of her pain pump. 12 COSTS There were no extra costs involved in this procedure. There is a potential for a cost saving over standard techniques because of the ability to address waist modification without liposuction in one procedure in selected cases. CONCLUSIONS The Scarpa s fascia bilateral advancement flap is a multilayer approach to enhance the waistline during all forms of abdominoplasty. The easy elevation of the superolateral based Scarpa s fascia flaps makes it a simple maneuver that can be widely applicable for all forms of abdominoplasties. It preserves the original fascia system and can improve surgical results while maintaining the benefits of the preservation of abdominal wall lymphatics. Supplementary Material This article contains supplementary material located online at Disclosures The authors declared no potential conflicts of interest with respect to the research, authorship, and publication of this article. Funding The authors received no financial support for the research, authorship, and publication of this article. REFERENCES 1. Nahas FX. Advancement of the external oblique muscle flap to improve the waistline: a study in cadavers. Plast Reconstr Surg. 2001;108(2): Nahas FX, Ferreira LM. Concepts on correction of the musculoaponeurotic layer in abdominoplasty. Clin Plast Surg. 2010;37(3): Costa-Ferreira A, Rebelo M, Vásconez LO, Amarante J. Scarpa fascia preservation during abdominoplasty: a prospective study. Plast Reconstr Surg. 2010;125(4): Fang RC, Lin SJ, Mustoe TA. Abdominoplasty flap elevation in a more superficial plane: decreasing the need for drains. Plast Reconstr Surg. 2010;125(2): Friedman T, Coon D, Kanbour-Shakir A, Michaels J 5th, Rubin JP. Defining the lymphatic system of the anterior abdominal wall: an anatomical study. Plast Reconstr Surg. 2015;135(4): Mossaad BM, Frame JD. Medial advancement of infraumbilical Scarpa s fascia improves waistline definition in Brazilian abdominoplasty. Aesthetic Plast Surg. 2013;37 (1): Saldanha OR, Pinto EB, Matos WN Jr, Lucon RL, Magalhães F, Bello EM. Lipoabdominoplasty without undermining. Aesthet Surg J. 2001;21(6): Saldanha OR, De Souza Pinto EB, Mattos WN Jr, et al. Lipoabdominoplasty with selective and safe undermining. Aesthetic Plast Surg. 2003;27(4): Saldanha OR, Federico R, Daher PF, et al. Lipoabdominoplasty. Plast Reconstr Surg. 2009;124 (3): Mallucci P, Pacifico MD, Waterhouse N, Sabbagh W. The differential fascial glide: a technical refinement in abdominoplasty. J Plast Reconstr Aesthet Surg. 2007;60(8): Lockwood TE. Superficial fascial system (SFS) of the trunk and extremities: a new concept. Plast Reconstr Surg. 1991;87(6): Whiteman DM, Kushins SI. Successful Resuscitation With Intralipid After Marcaine Overdose. Aesthet Surg J. 2014;34(5):

Champagne Groove Lipectomy: A Safe Technique to Contour the Upper Abdomen in Abdominoplasty

Champagne Groove Lipectomy: A Safe Technique to Contour the Upper Abdomen in Abdominoplasty Champagne Groove Lipectomy: A Safe Technique to Contour the Upper Abdomen in Abdominoplasty Ron Brooks, MD, Jonathan Nguyen, MD, Saeed Chowdhry, MD, John Paul Tutela, MD, Sean Kelishadi, MD, David Yonick,

More information

Controlled Results with Abdominoplasty

Controlled Results with Abdominoplasty Aesth. Plast. Surg. 25:357 364, 2001 DOI: 10.1007/s00266-001-0010-1 2001 Springer-Verlag New York Inc. Controlled Results with Abdominoplasty Richard A. Baxter, M.D., F.A.C.S. Mountlake Terrace, WA, USA

More information

Lipoabdominoplasty: Liposuction with Reduced Undermining and Traditional Abdominal Skin Flap Resection

Lipoabdominoplasty: Liposuction with Reduced Undermining and Traditional Abdominal Skin Flap Resection Aesth. Plast. Surg. 30:1 8, 2006 DOI: 10.1007/s00266-004-0084-7 Original Articles Lipoabdominoplasty: Liposuction with Reduced Undermining and Traditional Abdominal Skin Flap Resection Ruth Graf, M.D.,

More information

Lipoabdominoplasty: The Saldanha Technique

Lipoabdominoplasty: The Saldanha Technique Lipoabdominoplasty: The Saldanha Technique Osvaldo R. Saldanha, MD a, *,Sergio F.D. Azevedo, MD a,b,c, Pablo S.F. Delboni, MD a,b,c, Osvaldo R. Saldanha Filho, MD a,d, Cristianna B. Saldanha a,e, Luis

More information

Reducing Seroma in Outpatient Abdominoplasty: Analysis of 516 Consecutive Cases

Reducing Seroma in Outpatient Abdominoplasty: Analysis of 516 Consecutive Cases Body Contouring Reducing Seroma in Outpatient Abdominoplasty: Analysis of 516 Consecutive Cases Aesthetic Surgery Journal 30(3) 418 427 2010 The American Society for Aesthetic Plastic Surgery, Inc. Reprints

More information

No Drain Abdominoplasty: No More Excuses. Karol A Gutowski, MD, FACS

No Drain Abdominoplasty: No More Excuses. Karol A Gutowski, MD, FACS No Drain Abdominoplasty: No More Excuses Karol A Gutowski, MD, FACS Disclosures NO financial interests in any suture company Will use brand names due to lack of distinguishing generic names Objectives

More information

Deep-Plane Lipoabdominoplasty in East Asians

Deep-Plane Lipoabdominoplasty in East Asians Deep-Plane Lipoabdominoplasty in East Asians June-Kyu Kim 1, Jun-Young Jang 1, Yoon Gi Hong 2, Hyung Bo Sim 3, Sang Hoon Sun 3 1 Department of Plastic and Reconstructive Surgery, Kangbuk Samsung Medical

More information

Barbed Sutures in Progressive Tension Suture Technique Abdominoplasty. Karol A Gutowski, MD

Barbed Sutures in Progressive Tension Suture Technique Abdominoplasty. Karol A Gutowski, MD Barbed Sutures in Progressive Tension Suture Technique Abdominoplasty Karol A Gutowski, MD 1 Disclosures Speakers Bureau for AngioTech since April 2011 (Makers of Quill bi-directional barbed sutures) Technique

More information

Drains are Not Needed in Body Contouring Procedures. Karol A Gutowski, MD, FACS

Drains are Not Needed in Body Contouring Procedures. Karol A Gutowski, MD, FACS Drains are Not Needed in Body Contouring Procedures Karol A Gutowski, MD, FACS Drains are Not Needed in Body Contouring Procedures Karol A Gutowski, MD, FACS Disclosures The Doctors Company - Advisory

More information

Instant Identification of Redundant Tissue in Abdominoplasty With a Marking Grid

Instant Identification of Redundant Tissue in Abdominoplasty With a Marking Grid Body Contouring Instant Identification of Redundant Tissue in Abdominoplasty With a Marking Grid Edward A. Pechter, MD, FACS Standard abdominoplasty traditionally includes a transverse lower abdominal

More information

No Drain Abdominoplasty: No More Excuses. Karol A Gutowski, MD, FACS Instructional Course

No Drain Abdominoplasty: No More Excuses. Karol A Gutowski, MD, FACS Instructional Course No Drain Abdominoplasty: No More Excuses Karol A Gutowski, MD, FACS Instructional Course Disclosures Angiotech/Surgical Specialties - Advisory Board AxcelRx Pharmacuticals - Advisory Board Suneva Medical

More information

Anti-aging treatments that harness the hands of time

Anti-aging treatments that harness the hands of time www.cosmeticsurgerytimes.com Part of the Modified Avelar abdominoplasty 34 SEPTEMBER 2011 Vol. 14 No. 8 Flap resection for inner thigh lifting 36 Anti-aging treatments that harness the hands of time Facelifting

More information

Achieving ideal donor site aesthetics with autologous breast reconstruction

Achieving ideal donor site aesthetics with autologous breast reconstruction Review Article Achieving ideal donor site aesthetics with autologous breast reconstruction Maurice Y. Nahabedian Department of Plastic Surgery, Georgetown University, Washington, DC 20007, USA Correspondence

More information

Mons Pubis Ptosis: Classification and Strategy for Treatment

Mons Pubis Ptosis: Classification and Strategy for Treatment Aesth Plast Surg (2011) 35:24 30 DOI 10.1007/s00266-010-9552-4 ORIGINAL ARTICLE Mons Pubis Ptosis: Classification and Strategy for Treatment Hamdy A. El-Khatib Received: 2 April 2010 / Accepted: 25 June

More information

The introduction of lipoplasty into the surgical armamentarium by Illouz1 has. Lipoabdominoplasty Without Undermining

The introduction of lipoplasty into the surgical armamentarium by Illouz1 has. Lipoabdominoplasty Without Undermining Lipoabdominoplasty Without Undermining Osvaldo Ribeiro Saldanha, MD; Ewaldo olivar de Souza Pinto, MD; Wilson Novaes Matos, Jr., MD; Reynaldo L. Lucon, MD; Felipe Magalhães, MD; and Érika Mônica Lopes

More information

No Drain Abdominoplasty with Progressive Tension Sutures. Karol A Gutowski, MD, FACS

No Drain Abdominoplasty with Progressive Tension Sutures. Karol A Gutowski, MD, FACS No Drain Abdominoplasty with Progressive Tension Sutures Karol A Gutowski, MD, FACS Disclosures Suneva Medical Instructor Merz Advisory Board NO financial interests in any suture company Will use brand

More information

Repair of the Midline Fascial Defect in Abdominoplasty With Long-Acting Barbed and Smooth Absorbable Sutures

Repair of the Midline Fascial Defect in Abdominoplasty With Long-Acting Barbed and Smooth Absorbable Sutures Body Contouring Repair of the Midline Fascial Defect in Abdominoplasty With Long-Acting Barbed and Smooth Absorbable Sutures Aesthetic Surgery Journal 31(6) 668 673 2011 The American Society for Aesthetic

More information

Abdominal Wall Modification for the Difficult Ostomy

Abdominal Wall Modification for the Difficult Ostomy Abdominal Wall Modification for the Difficult Ostomy David E. Beck, M.D. 1 ABSTRACT A select group of patients with major stomal problems may benefit from operative modification of the abdominal wall.

More information

CASE REPORT An Innovative Solution to Complex Inguinal Defect: Deepithelialized SIEA Flap With Mini Abdominoplasty

CASE REPORT An Innovative Solution to Complex Inguinal Defect: Deepithelialized SIEA Flap With Mini Abdominoplasty CASE REPORT An Innovative Solution to Complex Inguinal Defect: Deepithelialized SIEA Flap With Mini Abdominoplasty Augustine Reid Wilson, MS, Justin Daggett, MD, Michael Harrington, MD, MPH, and Deniz

More information

We are IntechOpen, the world s leading publisher of Open Access books Built by scientists, for scientists. International authors and editors

We are IntechOpen, the world s leading publisher of Open Access books Built by scientists, for scientists. International authors and editors We are IntechOpen, the world s leading publisher of Open Access books Built by scientists, for scientists 4,100 116,000 120M Open access books available International authors and editors Downloads Our

More information

Truncal body contouring surgery in the massive weight loss patient

Truncal body contouring surgery in the massive weight loss patient Clin Plastic Surg 31 (2004) 611 624 Truncal body contouring surgery in the massive weight loss patient Al S. Aly, MD, FACS*, Albert E. Cram, MD, FACS, Claudette Heddens, MA, ARNP, CPSN, BSN Plastic Surgery,

More information

Superior Pedicle Vertical Scar Mammaplasty: Surgical Technique

Superior Pedicle Vertical Scar Mammaplasty: Surgical Technique Superior Pedicle Vertical Scar Mammaplasty: Surgical Technique 4 Foad Nahai A man honours himself by not displaying all the knowledge he has acquired. Folk Tradition Introduction I first tried the vertical

More information

The overlap of lipoplasty and abdominoplasty: indication, classification, and treatment

The overlap of lipoplasty and abdominoplasty: indication, classification, and treatment Clin Plastic Surg 31 (2004) 539 553 The overlap of lipoplasty and abdominoplasty: indication, classification, and treatment Luiz S. Toledo, MD Private Practice, Av. Brg. Luiz Antônio, 4442, São Paulo,

More information

-primarily by apposition of the anterior rectus

-primarily by apposition of the anterior rectus 2 Component separation Cop HARVEY CHIM, KAREN KIM EVANS, AND SAMIR MARDINI Mater al Introduction 7 Preoperative markings 7 Intraoperative details 9 Technique modification: Component separation with preservation

More information

Patient Safety in Postbariatric Body Contouring. Karol A Gutowski, MD, FACS

Patient Safety in Postbariatric Body Contouring. Karol A Gutowski, MD, FACS Patient Safety in Postbariatric Body Contouring Karol A Gutowski, MD, FACS Disclosures The Doctors Company - Advisory Board Angiotech/Quill - Advisory Board Suneva Medical Instructor Viora - Speaker Will

More information

2000 Winner. Robert F. Jackson, MD, F.A.C.S.

2000 Winner. Robert F. Jackson, MD, F.A.C.S. 2000 Winner Robert F. Jackson, MD, F.A.C.S. Contouring The Abdomen Using Liposuction, Rectus Plication,, and Crescent Tuck Abdominoplasty A Ten Year Experience Robert F. Jackson, M.D.,F.A.C.S. Contouring

More information

Tor Chiu. Deep Inferior Epigastric Artery Perforator Flap 161

Tor Chiu. Deep Inferior Epigastric Artery Perforator Flap 161 18 Deep Inferior Epigastric Artery Perforator Flap Tor Chiu Deep Inferior Epigastric Artery Perforator Flap 161 Deep Inferior Epigastric Artery Perforator Flap FLAP TERRITORY The deep inferior epigastric

More information

Body contouring by combined abdominoplasty and medial vertical thigh reduction: experience of 14 cases

Body contouring by combined abdominoplasty and medial vertical thigh reduction: experience of 14 cases The British Association of Plastic Surgeons (2004) 57, 222 227 Body contouring by combined abdominoplasty and medial vertical thigh reduction: experience of 14 cases M.G. Ellabban*, N.B. Hart Plastic Surgery

More information

The evolution of lipoplasty technique1 has in turn

The evolution of lipoplasty technique1 has in turn Full bdominoplasty With Circumferential Lipoplasty Lázaro Cárdenas-Camarena, MD; and Victor Laguna-arraza, MD Dr. Cárdenas-Camarena is from the Instituto Jalisciense de Cirugía Reconstructiva in Guadalajara,

More information

Aesthetic Surgery Journal

Aesthetic Surgery Journal Aesthetic Surgery Journal http://aes.sagepub.com/ Aesthetic and Functional Satisfaction After Monsplasty in the Massive Weight Loss Population Jacob M. P. Bloom, Emily Van Kouwenberg, Michael Davenport,

More information

Progressive Tension Sutures in Abdominoplasty: A Review of 597 Consecutive Cases

Progressive Tension Sutures in Abdominoplasty: A Review of 597 Consecutive Cases Body Contouring Progressive Tension Sutures in Abdominoplasty: A Review of 597 Consecutive Cases Todd A. Pollock, MD; and Harlan Pollock, MD Abdominoplasty is reportedly the fourth most common cosmetic

More information

Vertical mammaplasty has been developed

Vertical mammaplasty has been developed BREAST Y-Scar Vertical Mammaplasty David A. Hidalgo, M.D. New York, N.Y. Background: Vertical mammaplasty is an effective alternative to inverted-t methods. Among other benefits, it results in a significantly

More information

Selective salvage of zones 2 and 4 in the pedicled TRAM flap: a focus on reducing fat necrosis and improving aesthetic outcomes

Selective salvage of zones 2 and 4 in the pedicled TRAM flap: a focus on reducing fat necrosis and improving aesthetic outcomes DOI 10.1186/s40064-016-1714-7 RESEARCH Open Access Selective salvage of zones 2 and 4 in the pedicled TRAM flap: a focus on reducing fat necrosis and improving aesthetic outcomes Chi Sun Yoon and Kyu Nam

More information

Surgical Correction of Crow s Feet Deformity With Radiofrequency Current

Surgical Correction of Crow s Feet Deformity With Radiofrequency Current INTERNATIONAL CONTRIBUTION Oculoplastic Surgery Surgical Correction of Crow s Feet Deformity With Radiofrequency Current Min-Hee Ryu, MD; David Kahng, MD; and Yongho Shin, MD, PhD Aesthetic Surgery Journal

More information

Abdominoplasty was first described by Kelly COSMETIC

Abdominoplasty was first described by Kelly COSMETIC COSMETIC Outcomes of Traditional Cosmetic Abdominoplasty in a Community Setting: A Retrospective Analysis of 1008 Patients Keith C. Neaman, M.D. Shannon D. Armstrong, M.D. Marissa E. Baca, M.D. Mark Albert,

More information

CHAPTER 19 BODY CONTOURING. Ali A. Qureshi, MD and Sachin M. Shridharani, MD

CHAPTER 19 BODY CONTOURING. Ali A. Qureshi, MD and Sachin M. Shridharani, MD CHAPTER 19 BODY CONTOURING Ali A. Qureshi, MD and Sachin M. Shridharani, MD Body contouring is an umbrella term for aesthetic surgery of the body that includes the breasts, abdomen/trunk and upper and

More information

Despite breast reduction being one of the BREAST. Does Knowledge of the Initial Technique Affect Outcomes after Repeated Breast Reduction?

Despite breast reduction being one of the BREAST. Does Knowledge of the Initial Technique Affect Outcomes after Repeated Breast Reduction? BREAST Does Knowledge of the Initial Technique Affect Outcomes after Repeated Breast Reduction? Jamil Ahmad, M.D. Sarah M. McIsaac, M.D. Frank Lista, M.D. Mississauga and Ottawa, Ontario, Canada Background:

More information

ISPUB.COM. Abdominoplasty Combined With Treatment of Enterocutaneous Fistula. H Canter, E Hamaloglu INTRODUCTION CASE REPORT

ISPUB.COM. Abdominoplasty Combined With Treatment of Enterocutaneous Fistula. H Canter, E Hamaloglu INTRODUCTION CASE REPORT ISPUB.COM The Internet Journal of Surgery Volume 11 Number 1 Abdominoplasty Combined With Treatment of Enterocutaneous Fistula H Canter, E Hamaloglu Citation H Canter, E Hamaloglu. Abdominoplasty Combined

More information

Single-Layer Plication for Repair of Diastasis Recti: The Most Rapid and Efficient Technique

Single-Layer Plication for Repair of Diastasis Recti: The Most Rapid and Efficient Technique Body Contouring Single-Layer Plication for Repair of Diastasis Recti: The Most Rapid and Efficient Technique Aesthetic Surgery Journal 2017, Vol 37(6) 698 705 2017 The American Society for Aesthetic Plastic

More information

Breast Reconstruction with Superficial Inferior Epigastric Artery Flaps: A Prospective Comparison with TRAM and DIEP Flaps

Breast Reconstruction with Superficial Inferior Epigastric Artery Flaps: A Prospective Comparison with TRAM and DIEP Flaps Breast Reconstruction with Superficial Inferior Epigastric Artery Flaps: A Prospective Comparison with TRAM and DIEP Flaps Pierre M. Chevray, M.D., Ph.D. Houston, Texas Breast reconstruction using the

More information

cally, a distinct superior crease of the forehead marks this spot. The hairline and

cally, a distinct superior crease of the forehead marks this spot. The hairline and 4 Forehead The anatomical boundaries of the forehead unit are the natural hairline (in patients without alopecia), the zygomatic arch, the lower border of the eyebrows, and the nasal root (Fig. 4.1). The

More information

Periumbilical Perforator Sparing Component Separation

Periumbilical Perforator Sparing Component Separation CHAPTER 9 Periumbilical Perforator Sparing Component Separation Gregory A. Dumanian, MD 1. Introduction s Surgical site occurrences and surgical site infections (SSIs) are serious complications of ventral

More information

4/30/2010. Options for abdominal wall reconstruction. Scott L. Hansen, MD

4/30/2010. Options for abdominal wall reconstruction. Scott L. Hansen, MD Components Separation Scott L. Hansen, MD University of California, San Francisco Chief, Plastic and Reconstructive Surgery San Francisco General Hospital Overview Options for abdominal wall reconstruction

More information

AESTHETIC SURGERY OF THE BREAST: MASTOPEXY, AUGMENTATION & REDUCTION

AESTHETIC SURGERY OF THE BREAST: MASTOPEXY, AUGMENTATION & REDUCTION CHAPTER 18 AESTHETIC SURGERY OF THE BREAST: MASTOPEXY, AUGMENTATION & REDUCTION Ali A. Qureshi, MD and Smita R. Ramanadham, MD Aesthetic surgery of the breast aims to either correct ptosis with a mastopexy,

More information

Remodeling Bodylift with High Lateral Tension

Remodeling Bodylift with High Lateral Tension Aesth. Plast. Surg. 26:223 230, 2002 DOI: 10.1007/s00266-002-1478-z 2002 Springer-Verlag New York Inc. Remodeling Bodylift with High Lateral Tension J.F. Pascal, 1 and C. Le Louarn 1 Lyon, France 2 Paris,

More information

Early Experience With Barbed Sutures for Abdominal Closure in Deep Inferior Epigastric Perforator Flap Breast Reconstruction

Early Experience With Barbed Sutures for Abdominal Closure in Deep Inferior Epigastric Perforator Flap Breast Reconstruction Early Experience With Barbed Sutures for Abdominal Closure in Deep Inferior Epigastric Perforator Flap Breast Reconstruction Catherine de Blacam, MB, BCh, a Salih Colakoglu, MD, a Adeyiza O. Momoh, MD,

More information

This presentation will discuss the anatomy of the anterior abdominal wall as it pertains to gynaecological and obstetric surgery.

This presentation will discuss the anatomy of the anterior abdominal wall as it pertains to gynaecological and obstetric surgery. This presentation will discuss the anatomy of the anterior abdominal wall as it pertains to gynaecological and obstetric surgery. 1 The border of the anterior abdominal wall is defined superiorly by the

More information

Large full-thickness nasal tip defects after Mohs

Large full-thickness nasal tip defects after Mohs RECONSTRUCTIVE CONUNDRUM Repair of a Large, Exposed-Cartilage Nasal Tip Defect Using Nasalis-Based Subcutaneous Pedicle Flaps and Full-Thickness Skin Grafting DIEGO E. MARRA, MD, EDGAR F. FINCHER, MD,

More information

ABDOMINAL WALL & RECTUS SHEATH

ABDOMINAL WALL & RECTUS SHEATH ABDOMINAL WALL & RECTUS SHEATH Learning Objectives Describe the anatomy, innervation and functions of the muscles of the anterior, lateral and posterior abdominal walls. Discuss their functional relations

More information

Liposuction as an Adjunct to a Full Abdominoplasty Revisited

Liposuction as an Adjunct to a Full Abdominoplasty Revisited Cosmetic Follow-Up Liposuction as an Adjunct to a Full Abdominoplasty Revisited Alan Matarasso, M.D. New York, N.Y. This follow-up describes the observations and refinements I have made in the 5 years

More information

Case Report. XCM Biologic Tissue Matrix. Components separation using sandwich technique for reconstruction of abdominal wall defect.

Case Report. XCM Biologic Tissue Matrix. Components separation using sandwich technique for reconstruction of abdominal wall defect. Case Report XCM Biologic Tissue Matrix. Components separation using sandwich technique for reconstruction of abdominal wall defect. XCM Biologic Tissue Matrix. Components separation using sandwich technique

More information

Anatomical Landmarks for Safe Elevation of the Deep Inferior Epigastric Perforator Flap: A Cadaveric Study

Anatomical Landmarks for Safe Elevation of the Deep Inferior Epigastric Perforator Flap: A Cadaveric Study Anatomical Landmarks for Safe Elevation of the Deep Inferior Epigastric Perforator Flap: A Cadaveric Study Saeed Chowdhry, MD, Ron Hazani, MD, Philip Collis, BS, and Bradon J. Wilhelmi, MD University of

More information

MICHAEL J. BROWN, M.D., P.L.L.C. Aesthetic Cosmetic Plastic Surgery

MICHAEL J. BROWN, M.D., P.L.L.C. Aesthetic Cosmetic Plastic Surgery MICHAEL J. BROWN, M.D., P.L.L.C. Aesthetic Cosmetic Plastic Surgery INFORMED-CONSENT SUCTION ASSISTED LIPECTOMY SURGERY WITH FAT RE-INJECTION INSTRUCTIONS This is an informed-consent document that has

More information

THE ULTIMATE ART OF SCULPTURE ABDOMINOPLASTY. American University of Beirut Medical Center, Beirut, LEBANON

THE ULTIMATE ART OF SCULPTURE ABDOMINOPLASTY. American University of Beirut Medical Center, Beirut, LEBANON The Ultimate Art of Sculpture Abdominoplasty. Atiyeh BS, Ibrahim Amir, Hayek S. Ann Plast Surg Reconstr Microsurg, Vol 4, 2010, p. 75-93, ISSN: 1453-6587 THE ULTIMATE ART OF SCULPTURE ABDOMINOPLASTY Bishara

More information

Issues in Abdominoplasty

Issues in Abdominoplasty Editor s note: My thanks to the moderator, Armand A. Lucas, MD (board-certified plastic surgeon and ASAPS member, Cleveland, OH); and to panelists Joseph P. Hunstad, MD (board-certified plastic surgeon

More information

Fibrin Sealant and Lipoabdominoplasty in Obese Grade 1 and 2 Patients

Fibrin Sealant and Lipoabdominoplasty in Obese Grade 1 and 2 Patients Fibrin Sealant and Lipoabdominoplasty in Obese Grade 1 and 2 Patients Amr Abdel Wahab Mabrouk, Hesham Aly Helal, Soha Fathy Al Mekkawy, Nada Abdel Sattar Mahmoud, Ahmed Mohamed Abdel-Salam Plastic and

More information

Personal Evolution in Thighplasty Techniques for Patients Following Massive Weight Loss

Personal Evolution in Thighplasty Techniques for Patients Following Massive Weight Loss Body Contouring Personal Evolution in Thighplasty Techniques for Patients Following Massive Weight Loss Aesthetic Surgery Journal 2017, 1 12 2017 The American Society for Aesthetic Plastic Surgery, Inc.

More information

Tummy Tuck (Abdominoplasty)

Tummy Tuck (Abdominoplasty) Tummy Tuck (Abdominoplasty) Fitness and the appearance of fitness has become an obsession in our culture. Our torso shapes are revealed in form fitting clothing, in athletic garments and in the minimalist

More information

Gross Anatomy ABDOMEN/SESSION 1 Dr. Firas M. Ghazi

Gross Anatomy ABDOMEN/SESSION 1 Dr. Firas M. Ghazi Anterior Abdominal Wall Structure, muscles and surface anatomy Curricular Objectives By the end of this session students are expected to: Practical 1. Identify the hip and distinguish the three bones forming

More information

Do Preexisting Abdominal Scars Threaten Wound Healing in Abdominoplasty?

Do Preexisting Abdominal Scars Threaten Wound Healing in Abdominoplasty? Do Preexisting Abdominal Scars Threaten Wound Healing in Abdominoplasty? Michele A. Shermak, MD, Jessie Mallalieu, PA-C, and David Chang, PhD, MPH, MBA The Johns Hopkins Medical Institutions, Division

More information

JPRAS Open 3 (2015) 1e5. Contents lists available at ScienceDirect. JPRAS Open. journal homepage:

JPRAS Open 3 (2015) 1e5. Contents lists available at ScienceDirect. JPRAS Open. journal homepage: JPRAS Open 3 (2015) 1e5 Contents lists available at ScienceDirect JPRAS Open journal homepage: http://www.journals.elsevier.com/ jpras-open Case report The pedicled transverse partial latissimus dorsi

More information

MSCT in diagnostics of rectus abdominis diastasis

MSCT in diagnostics of rectus abdominis diastasis MSCT in diagnostics of rectus abdominis diastasis Poster No.: C-0021 Congress: ECR 2016 Type: Authors: Keywords: DOI: Scientific Exhibit D. Petrenko, O. Sharmazanova, N. Bortnuy; Kharkiv/UA Abdomen, Anatomy,

More information

Augmentation of the Ptotic Breast: Simultaneous Periareolar Mastopexy/Breast Augmentation By: Laurence Kirwan, M.D., F.R.C.S

Augmentation of the Ptotic Breast: Simultaneous Periareolar Mastopexy/Breast Augmentation By: Laurence Kirwan, M.D., F.R.C.S Augmentation of the Ptotic Breast: Simultaneous Periareolar Mastopexy/Breast Augmentation By: Laurence Kirwan, M.D., F.R.C.S Background: Submusculofascial augmentation of the ptotic breast can result in

More information

Clinical Study Analysis of Complications in Postbariatric Abdominoplasty: Our Experience

Clinical Study Analysis of Complications in Postbariatric Abdominoplasty: Our Experience Plastic Surgery International Volume 2015, Article ID 209173, 5 pages http://dx.doi.org/10.1155/2015/209173 Clinical Study Analysis of Complications in Postbariatric Abdominoplasty: Our Experience Michele

More information

Prevention of Implant Malposition in Inframammary Augmentation Mammaplasty

Prevention of Implant Malposition in Inframammary Augmentation Mammaplasty Prevention of Implant Malposition in Inframammary Augmentation Mammaplasty Yoon Ji Kim, Yang Woo Kim, Young Woo Cheon Department of Plastic and Reconstructive Surgery, Gachon University Gil Medical Center,

More information

This article appeared in a journal published by Elsevier. The attached copy is furnished to the author for internal non-commercial research and

This article appeared in a journal published by Elsevier. The attached copy is furnished to the author for internal non-commercial research and This article appeared in a journal published by Elsevier. The attached copy is furnished to the author for internal non-commercial research and education use, including for instruction at the authors institution

More information

Waist Curve Forming As An Adjuvant Procedure In Abdominoplasty

Waist Curve Forming As An Adjuvant Procedure In Abdominoplasty IOSR Journal of Dental and Medical Sciences (IOSR-JDMS) e-issn: 2279-0853, p-issn: 2279-0861.Volume 16, Issue 3 Ver. VIII (March. 2017), PP 121-125 www.iosrjournals.org Waist Curve Forming As An Adjuvant

More information

ALTERNATIVE TREATMENT

ALTERNATIVE TREATMENT INFORMED CONSENT LIPOSUCTION (SUCTION- ASSISTED LIPECTOMY SURGERY) (ULTRASOUND- ASSISTED LIPECTOMY SURGERY) (LASER ASSISTED LIPOSUCTION SURGERY) INSTRUCTIONS This is an informed- consent document that

More information

Reduction mammoplasty techniques in post-bariatric patients: our experience

Reduction mammoplasty techniques in post-bariatric patients: our experience Acta Biomed 2017; Vol. 88, N. 2: 156-160 DOI: 10.23750/abm.v88i2.5085 Mattioli 1885 Original article Reduction mammoplasty techniques in post-bariatric patients: our experience Susanna Polotto 1, Michele

More information

We are IntechOpen, the world s leading publisher of Open Access books Built by scientists, for scientists. International authors and editors

We are IntechOpen, the world s leading publisher of Open Access books Built by scientists, for scientists. International authors and editors We are IntechOpen, the world s leading publisher of Open Access books Built by scientists, for scientists 3,800 116,000 120M Open access books available International authors and editors Downloads Our

More information

Knee Disarticulation Amputation

Knee Disarticulation Amputation Knee Disarticulation Amputation Pre-Op 64 year old man, previous spinal cord injury, diabetes, renal failure, and a history of spasticity with dynamic knee flexion contracture. He had an open left ankle

More information

ONCOPLASTIC SURGERY. Dr. Sadir Alrawi Director of Surgical Oncology Services. Dr. Humaa Darr Surgical Oncology Fellow

ONCOPLASTIC SURGERY. Dr. Sadir Alrawi Director of Surgical Oncology Services. Dr. Humaa Darr Surgical Oncology Fellow Hessa St ONCOPLASTIC SURGERY Dr. Sadir Alrawi Director of Surgical Oncology Services Dr. Humaa Darr Surgical Oncology Fellow Al Sufouh Rd AL SUFOUH AL SUFOUH Sharaf DG Mall of the Emirates Mall Of the

More information

The history of face lift surgery encompasses a wide

The history of face lift surgery encompasses a wide Richard Ellenbogen, MD; Anthony Youn, MD; Dan Yamini, MD; and Steven Svehlak, MD Dr. Ellenbogen, Dr. Yamini, and Dr. Svehlak are in private practice in Los Angeles, CA. Dr. Youn is in private practice

More information

Scientific Forum. Nostrilplasty: Raising, Lowering, Widening, and Symmetry Correction of the Alar Rim

Scientific Forum. Nostrilplasty: Raising, Lowering, Widening, and Symmetry Correction of the Alar Rim Nostrilplasty: Raising, Lowering, Widening, and Symmetry Correction of the lar Rim Richard Ellenbogen, MD; and Greg azell, MD ackground: lthough the alar rim has frequently been neglected in correction

More information

INFORMED-CONSENT-ABDOMINOPLASTY SURGERY

INFORMED-CONSENT-ABDOMINOPLASTY SURGERY INFORMED-CONSENT-ABDOMINOPLASTY SURGERY 2000 American Society of Plastic Surgeons. Purchasers of the Patient Consultation Resource Book are given a limited license to modify documents contained herein

More information

Simultaneous Prosthetic Mesh Abdominal Wall Reconstruction with Abdominoplasty for Ventral Hernia and Severe Rectus Diastasis Repairs

Simultaneous Prosthetic Mesh Abdominal Wall Reconstruction with Abdominoplasty for Ventral Hernia and Severe Rectus Diastasis Repairs RECONSTRUCTIVE Simultaneous Prosthetic Mesh Abdominal Wall Reconstruction with Abdominoplasty for Ventral Hernia and Severe Rectus Diastasis Repairs Jennifer E. Cheesborough, M.D. Gregory A. Dumanian,

More information

Endoscopic Component Separation November Philip Omotosho, MD Assistant Professor of Surgery Duke University School of Medicine

Endoscopic Component Separation November Philip Omotosho, MD Assistant Professor of Surgery Duke University School of Medicine Endoscopic Component Separation November 2014 Philip Omotosho, MD Assistant Professor of Surgery Duke University School of Medicine Abdominal Wall Anatomy External Oblique Rectus Abdominus Internal Oblique

More information

Fascial Turn-Down Flap Repair of Chronic Achilles Tendon Rupture

Fascial Turn-Down Flap Repair of Chronic Achilles Tendon Rupture 19 Fascial Turn-Down Flap Repair of Chronic Achilles Tendon Rupture S. Ghosh, P. Laing, and Nicola Maffulli Introduction Fascial turn-down flaps can be used for an anatomic repair of chronic Achilles tendon

More information

Current Strategies in Breast Reconstruction

Current Strategies in Breast Reconstruction Current Strategies in Breast Reconstruction Hani Sbitany, MD Assistant Professor of Surgery University of California, San Francisco Division of Plastic and Reconstructive Surgery 12 th Annual School of

More information

OPEN ACCESS ATLAS OF OTOLARYNGOLOGY, HEAD & NECK OPERATIVE SURGERY

OPEN ACCESS ATLAS OF OTOLARYNGOLOGY, HEAD & NECK OPERATIVE SURGERY OPEN ACCESS ATLAS OF OTOLARYNGOLOGY, HEAD & NECK OPERATIVE SURGERY RECTUS ABDOMINIS FLAP FOR HEAD & NECK RECONSTRUCTION Patrik Pipkorn, Brian Nussenbaum The rectus abdominis flap is based on the deep inferior

More information

Case Study. TRAM Flap Reconstruction with an Associated Complication. Repair using DermaMatrix Acellular Dermis.

Case Study. TRAM Flap Reconstruction with an Associated Complication. Repair using DermaMatrix Acellular Dermis. Case Study TRAM Flap Reconstruction with an Associated Complication. Repair using DermaMatrix Acellular Dermis. TRAM Flap Reconstruction with an Associated Complication Challenge Insulin-dependent diabetes

More information

Management of postoperative pain following COSMETIC

Management of postoperative pain following COSMETIC COSMETIC Painless Abdominoplasty: The Efficacy of Combined Intercostal and Pararectus Blocks in Reducing Postoperative Pain and Recovery Time Lu-Jean Feng, M.D. Pepper Pike and Cleveland, Ohio Background:

More information

Reconstruction of the Breast after Cancer An Overview of Procedures and Options by Karen M. Horton, MD, MSc, FRCSC

Reconstruction of the Breast after Cancer An Overview of Procedures and Options by Karen M. Horton, MD, MSc, FRCSC Downloaded from Reconstruction of the Breast after Cancer An Overview of Procedures and Options by Karen M. Horton, MD, MSc, FRCSC What is Breast Reconstruction? Reconstruction of the breast involves recreating

More information

The progress in microsurgical procedures has led

The progress in microsurgical procedures has led Original Article Breast reconstruction with free anterolateral thigh flap Ranjit Raje, Ramesh Chepauk, Kanti Shetty, Rajendra Prasad J. S. Plastic & Reconstructive Services, Department of Surgical Oncology,

More information

Medieval times in surgery Still no solution for:

Medieval times in surgery Still no solution for: Medieval times in surgery Still no solution for: The most frequent complications of the abdominal surgeon: Adhesions Postoperative ileus Incisional hernia Anastomotic leakage Wound infection Incidence

More information

Policy No: FCHN.MP Page 1 of 6 Date Originated: Last Review Date Current Revision Date 7/10/07 06/2014 7/2/14

Policy No: FCHN.MP Page 1 of 6 Date Originated: Last Review Date Current Revision Date 7/10/07 06/2014 7/2/14 Page 1 of 6 Date Originated: Last Review Date Current Revision Date 7/10/07 06/2014 7/2/14 SUBJECT: Abdominoplasty, Panniculectomy and Ventral/Incisional Hernia RELATED POLICIES/RELATED DESKTOP PROCEDURES:

More information

The Superficial Inferior Epigastric Artery (SIEA) Flap and Its Applications in Breast Reconstruction

The Superficial Inferior Epigastric Artery (SIEA) Flap and Its Applications in Breast Reconstruction The Superficial Inferior Epigastric Artery (SIEA) Flap and Its Applications in Breast Reconstruction Zachary Menn and Aldona Spiegel Weill Cornell Medical College, The Methodist Hospital, Houston, Texas,

More information

Kenneth C. Shestak, M.D., Howard J. D. Edington, M.D., and Ronald R. Johnson, M.D.

Kenneth C. Shestak, M.D., Howard J. D. Edington, M.D., and Ronald R. Johnson, M.D. CME The Separation of Anatomic Components Technique for the Reconstruction of Massive Midline Abdominal Wall Defects: Anatomy, Surgical Technique, Applications, and Limitations Revisited Kenneth C. Shestak,

More information

REPAIR OF LARGE CYSTOCELE

REPAIR OF LARGE CYSTOCELE REPAIR OF LARGE CYSTOCELE WITH RAZ SUSPENSION 17 VAGINAL INCISION AND DISSECTION Premarin cream application to the anterior vagina daily for 1 month before cystocele repair enriches the vasculature and

More information

Breast Reconstruction Postmastectomy. Using DermaMatrix Acellular Dermis in breast reconstruction with tissue expander.

Breast Reconstruction Postmastectomy. Using DermaMatrix Acellular Dermis in breast reconstruction with tissue expander. Breast Reconstruction Postmastectomy. Using DermaMatrix Acellular Dermis in breast reconstruction with tissue expander. Strong and flexible Bacterially inactivated Provides implant support Breast Reconstruction

More information

Combined Use of Ultrasound-Assisted Liposuction and Limited-Incision Platysmaplasty for Treatment of the Aging Neck

Combined Use of Ultrasound-Assisted Liposuction and Limited-Incision Platysmaplasty for Treatment of the Aging Neck Aesth Plast Surg (2008) 32:790 794 DOI 10.1007/s00266-008-9215-x ORIGINAL ARTICLE Combined Use of Ultrasound-Assisted Liposuction and Limited-Incision Platysmaplasty for Treatment of the Aging Neck Patrick

More information

Abdominoplasty is an important and common

Abdominoplasty is an important and common Free full text on www.ijps.org Lipoabdominoplasty: A versatile and safe technique for abdominal contouring Mohan Rangaswamy Specialist Plastic Surgeon, Dubai, U.A.E. Address for correspondence: Mohan Rangaswamy,

More information

Breast Augmentation and Mastopexy Using a Pectoral Muscle Loop

Breast Augmentation and Mastopexy Using a Pectoral Muscle Loop Aesth Plast Surg (2011) 35:333 340 DOI 10.1007/s00266-010-9612-9 ORIGINAL ARTICLE Breast Augmentation and Mastopexy Using a Pectoral Muscle Loop André Auersvald Luiz Augusto Auersvald Received: 28 April

More information

Correcting Flank Skin Laxity and Dog Ear Plus Aggressive Liposuction: A Technique for Classic Abdominoplasty in Middle-Eastern Obese Women

Correcting Flank Skin Laxity and Dog Ear Plus Aggressive Liposuction: A Technique for Classic Abdominoplasty in Middle-Eastern Obese Women 78 Original Article Correcting Flank Skin Laxity and Dog Ear Plus Aggressive Liposuction: A Technique for Classic Abdominoplasty in Middle-Eastern Obese Women Seyed Nejat Hosseini1*, Ali Ammari1, Seyed

More information

PANNICULECTOMY AND BODY CONTOURING PROCEDURES

PANNICULECTOMY AND BODY CONTOURING PROCEDURES Oxford UnitedHealthcare Oxford Clinical Policy PANNICULECTOMY AND BODY CONTOURING PROCEDURES Policy Number: SURGERY 038.24 T2 Effective Date: October 1, 2018 Table of Contents Page INSTRUCTIONS FOR USE...

More information

INFORMED-CONSENT- ABDOMINOPLASTY SURGERY

INFORMED-CONSENT- ABDOMINOPLASTY SURGERY INFORMED-CONSENT- ABDOMINOPLASTY SURGERY INSTRUCTIONS This is an informed consent document that has been prepared by Dr. Taylor to inform you about abdominoplasty, the risks, and the alternative treatments.

More information

International Journal of Current Research and Academic Review ISSN: Volume 3 Number 1 (January-2015) pp

International Journal of Current Research and Academic Review ISSN: Volume 3 Number 1 (January-2015) pp International Journal of Current Research and Academic Review ISSN: 2347-3215 Volume 3 Number 1 (January-2015) pp. 348-354 www.ijcrar.com Study of Operative Procedures and their Indications in Management

More information

BREAST AUGMENTATION TECHNIQUES

BREAST AUGMENTATION TECHNIQUES BREAST AUGMENTATION TECHNIQUES Breast Augmentation Top Surgical Procedure in 2015 (Worldwide) Surgical Procedure : Breast Augmentation Rank : 1 Total : 1,488,992 Percent of Total Surgical Procedures :

More information

Components separation, originally described

Components separation, originally described IDEAS AND INNOVATIONS Use of Progressive Tension Sutures in Components Separation: Merging Cosmetic Surgery Techniques with Reconstructive Surgery Outcomes Jeffrey E. Janis, M.D. Dallas, Texas Summary:

More information

Essential Anatomy for oncoplastic surgery. Omar Z. Youssef M.D Professor of surgical oncology NCI- Cairo University

Essential Anatomy for oncoplastic surgery. Omar Z. Youssef M.D Professor of surgical oncology NCI- Cairo University Essential Anatomy for oncoplastic surgery Omar Z. Youssef M.D Professor of surgical oncology NCI- Cairo University Introduction Rationale for anatomical basis for OPS Anatomical considerations: 1. Surface

More information