As a result of the increasing popularity of
|
|
- Wendy Campbell
- 5 years ago
- Views:
Transcription
1 SPECIAL TOPIC Treating the Abdominotorso Region of the Massive Weight Loss Patient: An Algorithmic Approach Steven G. Wallach, M.D. New York, N.Y. Summary: There has been tremendous growth in the number of patients seeking body contouring procedures after massive weight loss. Most patients desire improvement of the abdominotorso region first. After massive weight loss, there is enormous variability of body proportions, and therefore there have been many surgical options proposed based on the quality of the skin, subcutaneous fat component, and location of the lax tissue. Each area needs to be assessed to see whether there is a significant lower abdominal component, an upper midline abdominal component, or contributions from the buttocks and flanks. An algorithm for treatment is presented to simplify the decision-making process. Patient examples are also shown to demonstrate the usefulness of the algorithm. (Plast. Reconstr. Surg. 121: 1431, 2008.) As a result of the increasing popularity of bariatric surgery, plastic surgeons are treating greater numbers of massive weight loss patients. These patients typically lose more than 100 pounds and have significant skin laxity with varying amounts of subcutaneous tissue excess. Commonly, the abdominotorso region is treated first; it often gives patients the most grief. The overhanging pannus may predispose this region to rashes and can make it difficult for patients to wear properly fitted clothing. Several authors have proposed systems that have become useful tools for classifying and treating patients desiring abdominal contour surgery. 1 3 However, these systems do not adequately classify the massive weight loss patients who are now seeking treatment. Recently, a classification of contour deformities after bariatric weight loss was described by Song et al. 4 The system involved evaluating 10 different anatomical regions commonly treated after massive weight loss. A table was used to illustrate preferred treatment plans for different From the Department of Plastic and Reconstructive Surgery, Albert Einstein College of Medicine; Lenox Hill Hospital; and Manhattan Eye, Ear, and Throat Hospital. Received for publication September 8, 2006; accepted December 20, Presented in part at Advances in Aesthetic Plastic Surgery: The Cutting Edge VI Symposium, in New York, New York, November 12 through 16, Copyright 2008 by the American Society of Plastic Surgeons DOI: /01.prs bf anatomical regions based on this rating system, but details regarding the different treatment plans were not elucidated. It is rare for a massive weight loss patient to undergo just a full abdominoplasty; treatment of the flanks and buttocks has become common. Therefore, many patients require a more involved procedure such as a circumferential abdominoplasty or even one that uses a fleur-de-lis approach. It stands to reason that a new system is necessary to classify and treat this subset of abdominotorso contour patients. In a fashion similar to the approach for arm contouring described by Appelt et al., 5 the author has developed an algorithm for treatment and classification of the abdominotorso region specifically for the massive weight loss patient. Included are descriptions of the procedures and patient examples illustrating the usefulness of the algorithm (Fig. 1). PREOPERATIVE EVALUATION A discussion with the patient is performed regarding their surgical goals, the various surgical treatment options, and the impact that their medical conditions can have on the surgical outcome. Surgery is usually delayed until the weight loss has Disclosure: The author has no commercial associations or financial disclosures that would pose or create a conflict of interest with information presented in this article
2 Plastic and Reconstructive Surgery April 2008 Fig. 1. Algorithm for treatment and classification of the abdominotorso region after massive weight loss. plateaued; for a bariatric surgery patient, this is usually after at least a 100-pound weight loss or longer than 1 year after the gastric procedure. Sometimes, surgery is performed sooner for a patient who requires a panniculectomy to assist in the management of other conditions. The patient is first examined in supine position and evaluated for hernias and the extent of rectus diastasis. A patient that has had an open abdominal procedure has an increased risk of hernia formation. 6,7 A massive weight loss patient may have an excess subcutaneous fat component, which can make palpation of a hernia difficult. Therefore, the hernia can remain occult until the time of surgery. The patient is then examined in the standing position. The abdominal region is evaluated for skin laxity and the extent of the subcutaneous fat component. Often, the patient will have striae, poor skin elasticity, and recalcitrant rashes not amenable to conservative treatment. A pinch test is performed in a horizontal fashion to evaluate the amount of tissue that can be excised. The horizontal pinch is performed on the lower transverse abdominal tissue that would be excised commonly during a routine full abdominoplasty. The laxity and quality of the skin are evaluated in a vertical dimension in the supraumbilical region as well. Using the vertical upper abdominal midline as a reference point, a vertical pinch is performed pinching tissue from each side of the midline to evaluate the upper abdominal midline excess and laxity. If a vertical pinch improves the upper abdominal waistline and can eliminate supraumbilical fullness, the possibility of performing a vertical midline incision is discussed. The threshold for using this additional incision is lowered if the patient has a preexisting paramedian or midline vertical scar. The patient is then examined for mons pubis ptosis. 8 This is marked in accordance with Baroudi s description, leaving a 5- to 7-cm length from the vulvar commissure to the top of the mons pubis. 9 The patient is evaluated in a right lateral, left lateral, and posterior standing position using the horizontal pinch test to evaluate the impact the pinch has on lateral and anterior thigh laxity and buttock ptosis 10 (Table 1). The preoperative examination is essential because there is tremendous variability of skin quality, amount of the subcutaneous fat, and distribu- 1432
3 Volume 121, Number 4 Contouring after Massive Weight Loss Table 1. Massive Weight Loss Abdominotorso Classification System Type Fat Vertical Abdomen Laxity (girth) Flank/Buttock Component Treatment I Variable Minimal Minimal Full abdominoplasty II Variable Moderate to severe Moderate to severe Fleur-de-lis abdominoplasty III Variable Minimal to moderate Moderate to severe Circumferential abdominoplasty IV Variable Severe Moderate to severe Fleur-de-lis circumferential abdominoplasty V Severe Moderate to severe Moderate to severe Panniculectomy tion of tissue laxity in these patients. Furthermore, it is during this period when the risks, benefits, and alternatives of all procedure options can be discussed thoroughly with the patient. CLASSIFICATION SYSTEM Type I: Full Abdominoplasty This patient has moderate abdominal skin laxity with variable amounts of subcutaneous fat. The vertical skin and subcutaneous component contributing to the abdominal girth is minimal. The laxity in the upper abdomen can be treated by superior elevation and excision in a transverse fashion along the lower abdomen as performed for non massive weight loss patients. The flanks and buttocks are not significantly lax and are not treated. Repair of the rectus diastasis is performed. This patient has fairly good skin elasticity that contributes to the resiliency of the tissues, precluding the need for a more involved procedure. I have found this more commonly in the younger massive weight loss patient or in those patients who have had less than a 100-pound weight loss. However, in general, this massive weight loss patient is not common. Traditional abdominoplasty procedures have been described elsewhere Two closed suction drains are placed in the mons pubis region through separate stab incisions. They are removed once the total fluid is less than 30 cc/24-hour period, usually within 1 week. The patient is encouraged to ambulate the first night of surgery and is to wear an abdominal binder for 3 to 6 weeks (Fig. 2). Type II: Fleur-de-Lis Abdominoplasty A massive weight loss patient ideally fitting this profile is more theoretical than an actual patient. If individuals have enough vertical laxity to warrant a fleur-de-lis, they will likely have similar laxity of the flanks and buttocks, requiring a circumferential procedure. Unlike the type I patient, there is significant vertical laxity contributing to the overall girth that cannot be treated alone by undermining and excision along the lower abdomen. Furthermore, diastasis repair alone will not significantly narrow this patient. The superior flap is undermined and the redundant tissue is resected in the vertical midline to decrease the overall girth. The redundant transverse component is then resected once the vertical component is reconciled The key to the closure is minimal tension. This patient is not flexed more than 20 to 30 degrees to remove the excess tissue. The postsurgical care is similar to that used for the type I patient; however, I find that the drains stay in for several days longer (Fig. 3). Type III: Circumferential Abdominoplasty This procedure is indicated for a patient with moderate to severe skin laxity of the abdominal skin with a significant flank/buttock component. The patient may have minimal to moderate excess in the supraumbilical component that can be treated by undermining alone and excising along the lower transverse abdomen. 10,22 26 In addition, the patient requires resection of the flank/buttock component to treat the laxity. After anesthetic induction, the patient is placed prone and the buttocks and flanks are treated first. The excess tissue is resected and closed without tension or significant undermining. The patient is then placed supine and the abdominal component is treated. The patient is flexed 5 to 10 degrees for final excision and closure of the lower transverse abdomen. The postsurgical care is similar to that described earlier, with the exception that four closed suction drains are placed. Two drain the buttock and flank region and two drain the abdominal region. These drains will often be kept in for 2 to 3 weeks (Fig. 4). Type IV: Fleur-de-Lis Circumferential Abdominoplasty This patient has significant upper abdominal laxity, and redundancy in the lower abdomen requiring both vertical and transverse excision. The flank and buttock regions contribute to the overall laxity and require treatment. There is noticeable laxity in the upper midline that contributes to the overall girth of the patient that cannot be treated by 1433
4 Plastic and Reconstructive Surgery April 2008 Fig. 2. A 36-year-old woman, 5 feet 2 inches tall, after a 78-pound weight loss, with good skin tone and laxity confined mainly to the lower abdomen. Preoperative (left) and 3-week postoperative appearance (right) following a full abdominoplasty. just undermining of the superior flap and resection along the inferior abdominal incision. Technical variations for treatment have been described elsewhere As with the type III patient, the patient is placed prone and the buttock and flank tissue is excised without undermining and with minimal tension. The patient is then placed supine and the abdominal component is treated. Once the superior flap is elevated, the excess in the vertical midline is treated. The patient is flexed 5 to 10 degrees and the redundant lower abdominal transverse component is excised. There is no tension on the closure. The keys to this procedure are in the initial marking of the patient, which is used as a guideline during the surgical procedure, and minimizing the abdominal closure tension (Figs. 5 and 6). Type V: Panniculectomy This is reserved for a patient who has significant amounts of subcutaneous fat with moder- 1434
5 Volume 121, Number 4 Contouring after Massive Weight Loss Fig. 3. A 48-year-old woman, 5 feet 2 inches tall, after a 101-pound weight loss. She had had a recurrent umbilical hernia and multiple scars on her abdomen. The patient had significant laxity of her lower abdomen, her vertical midline abdomen, and her flanks and buttocks. The patient chose not to have the flanks and buttocks treated at the time of surgery. Appearance preoperatively (left) and 7 months after fleur-de-lis abdominoplasty and 1 month after umbilicoplasty (right). ate to severe skin laxity. This patient is best treated after his or her goal weight is achieved, when the patient can be assigned to a type I to IV abdominotorso group. Unfortunately, because of hygiene issues or the need to perform other surgical procedures (i.e., general surgical, gynecologic, or urologic procedures), the pannus is obstructing access and requires excision. This patient is still overweight and has significant surgical risks including delayed wound healing Delaying surgery until weight loss is complete is preferable, because the risks of surgery are significantly diminished. 28 Excision of the pannus is performed without undermining to avoid creating poorly perfused tissue and to decrease the risk of seroma formation. In some instances, the umbilicus may have to be sacrificed 26,28,29 (Fig. 7). 1435
6 Plastic and Reconstructive Surgery April 2008 Fig. 4. A 34-year-old man, 6 feet 1 inch tall, after a 145-pound weight loss, with moderate skin laxity and significant lower abdominal transverse laxity and significant buttock and flank laxity. He had an upper midline vertical scar. He did not have significant vertical abdominal skin laxity. He was a good candidate for a circumferential abdominoplasty. Preoperative (left) and 3-month postoperative (right) appearance following a full abdominoplasty. CASE REPORTS Case 1 A 36-year-old woman, 5 feet 2 inches tall and initially weighing 228 pounds, lost 78 pounds after undergoing a laparoscopic gastric bypass and weighed 150 pounds. On physical examination, she had moderate skin laxity confined to her lower abdomen, with minimal upper midline vertical skin laxity. She was classified as a type I patient that underwent a full abdominoplasty. Her 3-week postoperative photographs are shown (Fig. 2). Case 2 A 48-year-old woman, 5 feet 2 inches tall and initially weighing 275 pounds, lost 101 pounds after her gastric bypass and weighed 174 pounds. The patient had significant skin laxity of her abdomen, flanks, and buttocks, including severe supraumbilical laxity. She had a reducible umbilical hernia. She also had an upper vertical midline scar, a prior appendectomy scar, and previous laparoscopic bypass incisions. Although she was a good candidate for a type IV procedure, she opted to be down-staged to a type II, fleur-de-lis abdominoplasty for financial reasons. At the time of her combined type II procedure and umbilical 1436
7 Volume 121, Number 4 Contouring after Massive Weight Loss Fig. 5. A 47-year-old woman, 5 feet 6 inches tall, after a 107-pound weight loss. She had significant transverse and vertical abdominal skin laxity. She also had significant flank and buttock laxity. She had prior cesarean section surgery resulting in a lower midline vertical incision and a Pfannenstiel incision. Appearance preoperatively (left) and 6 months after a fleur-de-lis circumferential abdominoplasty (right). hernia repair, the general surgeon elected to amputate her umbilical stalk. The patient underwent an umbilicoplasty 6½ months after the type II operation. Photographs of the 7½month result from the type II procedure and 1 month after her umbilicoplasty are shown (Fig. 3). Case 3 A 34-year-old man, 6 feet 1 inch tall and initially weighing 360 pounds, lost 145 pounds after an open gastric bypass procedure and subsequently weighed 215 pounds. On physical examination, he had moderate skin laxity confined to the lower abdomen and a moderate amount of subcutaneous fat. He also had significant buttock and flank laxity. The patient had an upper midline vertical scar that he did not want revised. He was classified as a type III patient. His 3-month postoperative result is shown (Fig. 4). Case 4 A 47-year-old woman, 5 feet 6 inches tall and initially weighing 285 pounds, subsequently weighed 178 pounds after a laparoscopic gastric bypass. On physical examination, she had sig- 1437
8 Plastic and Reconstructive Surgery April 2008 Fig. 6. Additional views of the patient shown in Figure 5. Fig. 7. A 43-year-old woman, 5 feet 6 inches tall, after a 78-pound weight loss, with a large painful umbilical hernia. The patient had significant skin laxity and rashes below her large abdominal pannus. She had a significant amount of fat in her subcutaneous component circumferentially and had a previous upper vertical midline incision. She was still actively losing weight. Because she needed to have her umbilical hernia treated but was still severely overweight, she was a good candidate for a panniculectomy. Preoperative view(left) and 16 months after panniculectomy with umbilical sacrifice (right). nificant transverse and vertical laxity of the abdomen and significant flank and buttock laxity. She had undergone three prior cesarean sections: one by means of a lower midline vertical abdominal incision and the others through a Pfannenstiel incision. She was an excellent candidate for a type IV procedure. Her 6½-month postoperative photographs are shown (Figs. 5 and 6). She was pleased with her postoperative result but developed meralgia paresthetica in her left upper thigh. 1438
9 Volume 121, Number 4 Contouring after Massive Weight Loss Case 5 A 43 year-old woman, 5 feet 6 inches tall and initially weighing 303 pounds, weighed 225 pounds after an open gastric bypass and was not at her ideal weight. She was referred by her bariatric surgeon to remove the pannus in conjunction with treatment of her painful umbilical hernia. On physical examination, the patient had a large reducible umbilical hernia and an upper midline vertical scar. She had significant skin laxity and rashes below her abdominal pannus. She was a candidate for type V procedure at this time and desired further treatment of other anatomical regions once her weight loss was complete. The patient underwent a type V procedure (panniculectomy) combined with an umbilical hernia repair and sacrifice of her umbilicus. Sixteen-month postoperative results are shown (Fig. 7). DISCUSSION The algorithm described is based on ideal patient conditions so that general guidelines can be used as a starting point for patient classification and treatment. Most massive weight loss patients who desire abdominal contour surgery fall into the five general treatment categories that I have described previously. Types I through IV are those patients who have reached their goal weight. The type V patient (i.e., one that requires a panniculectomy) is the one that has not reached her ideal body weight but requires excision of the abdominal pannus to facilitate other surgical procedures (i.e., gynecologic, urologic, or general surgical procedures). The classification system described is simple and straightforward (Fig. 1). Although many of the patient categories appear to have very similar characteristics, there are unique differences. A type I patient has minimal supraumbilical vertical pinch laxity and does not have flank or buttock laxity. Both the type II patient and the type IV patient have severe vertical abdominal laxity demonstrated by a significant vertical pinch; this differentiates them from the other types. What should differentiate the type II from the type IV patient is that the type IV patient also has significant flank and buttock laxity, warranting a circumferential procedure. In my experience, a type II patient is a theoretical entity. I do not think the patient really exists in the sense that she could only have significant vertical upper midline laxity without also having flank and buttock laxity. The type II patient that I encounter is originally classified as a type IV patient but, because the patient may not be able to afford the circumferential procedure or may not want the increased surgical risk of a lengthier and more complex surgical procedure and/or the potential increased downtime from the procedure, opts to be down-staged to have a type II procedure. The type III patient does not have significant supraumbilical fullness or laxity that, on performing a vertical pinch, warrants a fleur-de-lis procedure yet still has the laxity in the flanks and buttocks that warrants a circumferential procedure. Abdominotorso contour surgery in the massive weight loss patient involves a complex decision-making process to ensure the best result with the least amount of complications. 20,21,26,30,31 With this, there are certain tradeoffs that a massive weight loss patient must consider when choosing an abdominotorso contouring procedure. These include the following: reconciliation of scarring versus additional contour improvement, the amount of time that the patient can take off from work or daily activities, and the potential financial obligations that may impact the choice of surgical procedure. More extensive procedures will probably require a longer convalescence period, additional incisions, and often a greater financial burden, all of which impact the patient s decision. Certainly, many variables including those described above can impact the procedure choice, and in some cases downstaging to a lesser procedure may be appropriate. Prior surgical procedures can impact the choice of treatment. There has been some debate regarding abdominoplasty after open cholecystectomy because of the potential of having a limited blood supply to tissue that would end up between the new lower abdominal scar and the cholecystectomy scar. 32,33 Chevron incisions in the upper midline may lead to consideration of using a reverse abdominoplasty Commonly, a McBurney incision, a lower midline or paramedian vertical incision, and a Pfannenstiel incision can usually be removed when performing one of the five procedures described. Having a vertical upper midline abdominal scar may tether and restrict movement of the upper abdominal flap. A simple scar revision for a patient without significant midline vertical laxity or using a fleur-de-lis approach for the patient that does have significant vertical laxity can alleviate this problem. Often, the massive weight loss patient requests treatment of several different anatomical regions. Combining surgical procedures in addition to the abdominotorso contour procedure can impact the treatment choice as well. Sometimes, these may be performed together during the same operative session. However, performing combined procedures will increase the length of surgery and complexity, and may increase the risk of complications, requirement for blood transfusions, and need for extended hospital stays, 37,38 although 1439
10 Plastic and Reconstructive Surgery April 2008 some studies do not support the potential increased complication risk The patient may be down-staged to a less invasive abdominotorso procedure while also treating the additional anatomical region, so that these risks can be minimized. For instance, a mastopexy or breast reduction procedure using a Wise pattern performed in combination with an abdominal contour procedure may impact the blood supply to the abdominal flap, especially with a fleur-de-lis approach, and so down-staging may be appropriate. Sometimes, the massive weight loss patient requires hernia repair, and this can be performed in conjunction with their abdominotorso contour procedure. An umbilical or incisional hernia usually does not affect the choice of surgical procedure but may impact the complexity and length of the procedure, potentially increasing the risks as well Hernia repair in conjunction with an abdominotorso contour procedure may impact the viability of the umbilicus (see case 2), and when a ventral hernia is repaired, it may impede the quality of the diastasis repair. The algorithmic approach is set up for the ideal situation, barring contributory medical conditions, scarring, hernia repair, or combined procedures. The algorithm is presented to provide an easy, reliable method with which to classify patients so that an adequate treatment plan can be offered. Steven G. Wallach, M.D Fifth Avenue, Suite 2D New York, N.Y sgwallach@aol.com ACKNOWLEDGMENTS The author thanks Eric A. Appelt, M.D., Jeffrey E. Janis, M.D., and Rod J. Rohrich, M.D., for inspiring him to submit this article after reading their article entitled An Algorithmic Approach to Upper Arm Contour (Plast. Reconstr. Surg. 118: 237, 2006). REFERENCES 1. Avelar, J. Fat suction versus abdominoplasty. Aesthetic Plast. Surg. 9: 265, Bozola, A. R., and Psillakis, J. M. Abdominoplasty: A new concept and classification for treatment. Plast. Reconstr. Surg. 82: 983, Matarasso, A. Abdominolipoplasty: A system of classification and treatment for combined abdominoplasty and suction assisted lipectomy. Aesthetic Plast. Surg. 15: 111, Song, A. Y., Jean, R. D., Hurwitz, D. J., et al. A classification of contour deformities after bariatric weight loss: The Pittsburgh Rating Scale. Plast. Reconstr. Surg. 116: 1535, Appelt, E. A., Janis, J. E., and Rohrich, R. J. An algorithmic approach to upper arm contouring. Plast. Reconstr. Surg. 118: 237, Podnos, Y. D., Jiminez, J. C., Wilson, S. E., et al. Complications after laparoscopic gastric bypass: A review of 3464 cases. Arch. Surg. 138: 957, Hesselnik, V. J., Luijendijk, R. W., de Witt, J. H. W., et al. An evaluation of risk factors in incisional hernia recurrence. Surg. Gynecol. Obstet. 176: 228, Matarasso, A., and Wallach, S. G. Abdominal contour surgery: Treating all of the aesthetic units including the mons pubis. Aesthetic Surg. J. 21: 111, Baroudi, R., and Ferreira, A. A. Contouring the hip and the abdomen. Clin. Plast. Surg. 23: 551, Lockwood, T. E. Transverse flank-thigh-buttock lift with superficial fascial suspension. Plast. Reconstr. Surg. 87: 1019, Baroudi, R., and Moraes, M. A bicycle-handlebar type of incision for primary and secondary abdominoplasty. Aesthetic Plast. Surg. 19: 307, Grazer, F. M. Abdominoplasty. Plast. Reconstr. Surg. 51: 617, Lockwood, T. Lower body lift with superficial fascial suspension. Plast. Reconstr. Surg. 92: 1112, Pitanguy, I. Abdominal lipectomy. Clin. Plast. Surg. 2: 401, Planas, J. The vest over pants abdominoplasty. Plast. Reconstr. Surg. 61: 694, Regnault, P. Abdominoplasty by the W technique. Plast. Reconstr. Surg. 55: 265, Castanares, S., and Goethel, J. A. Abdominal lipectomy: A modification in technique. Plast. Reconstr. Surg. 40: 378, Costa, L. F., Landecker, A., and Manta, A. M. Optimizing body contour in massive weight loss patients: The modified vertical abdominoplasty. Plast. Reconstr. Surg. 114: 1917, Dellon, A. L. Fleur-de-lis abdominoplasty. Aesthetic Plast. Surg. 9: 27, Duff, C. G., Aslam, S., and Griffiths, R. W. Fleur-de-lys abdominoplasty: A consecutive case series. Br. J. Plast. Surg. 56: 557, Wallach, S. G. Abdominal contour surgery for the massive weight loss patient: The fleur-de-lis approach. Aesthetic Surg. J. 25: 454, Aly, A. S., Cram, A. E., Chao, M, et al. Belt lipectomy for circumferential truncal excess: The University of Iowa experience. Plast. Reconstr. Surg. 111: 398, Gonzalez-Ulloa, M. Belt lipectomy. Br. J. Plast. Surg. 13: 179, Hunstad, J. P. Body contouring in the obese patient. Clin. Plast. Surg. 23: 647, Muhlbauer, W. Radical abdominoplasty, including body shaping: Representative cases. Aesthetic Plast. Surg. 13: 105, Strauch, B., Herman, C., Rohde, C., and Baum, T. Mid-body contouring in the post-bariatric surgery patient. Plast. Reconstr. Surg. 117: 2200, Matory, W. E., Jr., O Sullivan, J., Fudem, G., and Dunn, R. Abdominal surgery in patients with severe morbid obesity. Plast. Reconstr. Surg. 94: 976, Vastine, V. L., Morgan, R. F., Gampper, T. J., et al. Wound complications of abdominoplasty in obese patients. Ann. Plast. Surg. 42: 34, Petty, P., Manson, P., Black, R., et al. Panniculus morbidus. Ann. Plast. Surg. 28: 442,
11 Volume 121, Number 4 Contouring after Massive Weight Loss 30. Matory, W. E., Jr., O Sullivan, J., Fudem, G., and Dunn, R. Abdominal surgery in patients with severe morbid obesity. Plast. Reconstr. Surg. 94: 976, Vastine, V. L., Morgan, R. F., Gampper, T. J., et al. Wound complications of abdominoplasty in obese patients. Ann. Plast. Surg. 42: 34, Cardoso de Castro, C., Aboudib, J. H., Jr., Salema, R., Gradel, J., and Braga, L. How to deal with abdominoplasty in an abdomen with a scar. Aesthetic Plast. Surg. 17: 67, El-Khatib, H. A., and Bener, A. Abdominal dermolipectomy in an abdomen with pre-existing scars: A different concept. Plast. Reconstr. Surg. 114: 992, Akbas, H., Guneren, E., Eroglu, L., Demir, A., and Uysal, A. The combined use of classic and reverse abdominoplasty on the same patient. Plast. Reconstr. Surg. 109: 2595, Baroudi, R., Keppke, E. M., and Carvalho, C. G. Mammary reduction combined with reverse abdominoplasty. Ann. Plast. Surg. 2: 368, Hurwitz, D. J., and Agha-Mohammadi, S. Postbariatric surgery breast reshaping: The spiral flap. Ann. Plast. Surg. 56: 481, Hunter, G. R., Carpo, R. O., Broadbent, T. R., and Woolf, R. M. Pulmonary complications following abdominal lipectomy. Plast. Reconstr. Surg. 71: 809, Voss, S. C., Sharp, H. C., and Scott, J. R. Abdominoplasty combined with gynecologic surgical procedures. Obstet. Gynecol. 67: 181, Gemperli, R., Neves, R. I., Tuma, P., Jr., Bonamichi, G. T., Ferreira, M. C., and Manders, E. K. Abdominoplasty combined with other intraabdominal procedures. Ann. Plast. Surg. 29: 18, Hester, T. R., Jr., Baird, W., Bostwick, J., III, Nahai, F., and Cukic, J. Abdominoplasty combined with other major surgical procedures: Safe or sorry? Plast. Reconstr. Surg. 83: 997, Shull, B. L., and Verheyden, C. N. Combined plastic and gynecological surgical procedures. Ann. Plast. Surg. 20: 552, e-tocs and e-alerts Receive the latest developments in plastic and reconstructive surgery. Request the delivery of Plastic and Reconstructive Surgery s e-alerts directly to your address. This is a fast, easy, and free service to all subscribers. You will receive: Notice of all new issues of Plastic and Reconstructive Surgery, including the posting of a new issue on the PRS-Online Web site Complete Table of Contents for all new issues Visit and click on e-alerts. 1441
F ORUM. Abdominal Contour Surgery for the Massive Weight Loss Patient: The Fleur-De-Lis Approach. Steven G. Wallach, MD
Steven G. Wallach, MD Dr. Wallach is Assistant Clinical Professor of Plastic Surgery, Albert Einstein College of Medicine, Bronx, NY; Assistant Adjunct Physician, Lenox Hill Hospital; and Assistant Attending
More informationSusan A. Williams, PA-C, Raffi Gurunluoglu, MD, PhD, Correspondence:
Umbilical Transposition in Functional Panniculectomy of the Massive Weight Loss Patient: Is It Aesthetic eplasty: Vol. 12 Umbilical Transposition in Functional Panniculectomy of the Massive Weigh Raffi
More informationISPUB.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 informationChampagne 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 informationMons 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 informationThe latest statistics from the National Center for. Correlation of Complications of Body Contouring Surgery With Increasing Body Mass Index
Correlation of Complications of Body Contouring Surgery With Increasing Body Mass Index The latest statistics from the National Center for Health Statistics state that 30% of U.S. adults over the age of
More informationControlled 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 informationTruncal 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 informationBody 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 informationWe 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 informationAbdominal contour surgery has undergone a number of refinements as our understanding
bdominal Contour Surgery: Treating ll esthetic Units, Including the Mons Pubis lan Matarasso, MD; and Steven G. Wallach, MD ackground: Many patients who seek abdominal contour surgery also desire improvement
More informationAbdominoplasty/Panniculectomy/Ventral Hernia Repair
Abdominoplasty/Panniculectomy/Ventral Hernia Repair POLICY Abdominoplasty, known more commonly as a "tummy tuck," is a surgical procedure to remove excess skin and fat from the middle and lower abdomen
More informationCHAPTER 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 informationPolicy 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 informationMedical Policy An Independent Licensee of the Blue Cross and Blue Shield Association
Panniculectomy and Abdominoplasty Page 1 of 7 Medical Policy An Independent Licensee of the Blue Cross and Blue Shield Association Title: Panniculectomy and Abdominoplasty Professional Institutional Original
More informationDo 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 informationScientific Forum. Extreme Cosmetic Surgery: A Retrospective Study of Morbidity in Patients Undergoing Combined Procedures
W. Grant Stevens, MD; Steven D. Vath, MD; and David A. Stoker, MD Dr. Stevens is Associate Clinical Professor, Division of Plastic and Reconstructive Surgery, Department of Surgery, University of Southern
More informationReducing 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 informationThe Changing Body After Bariatric Surgery Plastic Surgery & Other Options. Al Aly, MD, FACS
The Changing Body After Bariatric Surgery Plastic Surgery & Other Options Al Aly, MD, FACS Professor of Plastic Surgery Director of Aesthetic Plastic Surgery University of California Irvine Overview Why
More informationAesthetic 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 informationPanniculectomy and Abdominoplasty
Medical Coverage Policy Panniculectomy and Abdominoplasty Table of Contents Effective Date... 3/15/2018 Next Review Date... 3/15/2019 Coverage Policy Number... 0027 Related Coverage Resources Coverage
More informationCigna Medical Coverage Policy
Cigna Medical Coverage Policy Subject Panniculectomy and Abdominoplasty Table of Contents Coverage Policy... 1 General Background... 2 Coding/Billing Information... 4 References... 5 Effective Date...
More informationPANNICULECTOMY 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 informationThe 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 informationLiposuction 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 informationRemodeling 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 informationInstant 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 informationAbdominal 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 informationAbdominoplasty/Panniculectomy/Lipectomy
Abdominoplasty/Panniculectomy/Lipectomy Description of Procedure or Service Panniculectomy is a surgical procedure used to remove a panniculus, which is an apron of fat and skin that hangs from the front
More informationVertical 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 informationLipoabdominoplasty: 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 informationAchieving 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 informationFAQ When is excess skin removal considered reconstructive vs cosmetic?
Excess Skin Removal Surgery FAQ When is excess skin removal considered reconstructive vs cosmetic? Under California s Reconstructive Statute, Health & Safety Code section 1367.63: Surgery EITHER to improve
More informationABDOMINOPLASTY TUMMY TUCK
ABDOMINOPLASTY TUMMY TUCK Modified Brazilian Technique... 1-20 Hernia Repair - Modified Brazilian Tummy Tuck... 21-23 Fleur de Lys... 24-25 Apronectomy... 26 Mini Tummy Tuck... 27 This is a procedure which
More informationBreast 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 informationCASE 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 informationAbdominoplasty 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 informationAbdominal Lipectomy: A Prospective Outcomes Study
Abdominal Lipectomy: A Prospective Outcomes Study Abstract Context/objective: Abdominal lipectomy is performed by plastic surgeons to provide symptomatic, functional, and cosmetic relief for patients with
More informationABDOMINOPLASTY FOR PATIENT WHO HAS UNDERGONE GASTRIC BYPASS SURGERY UAB HOSPITAL, BIRMINGHAM, AL Broadcast June 20, 2005
NARRATOR ABDOMINOPLASTY FOR PATIENT WHO HAS UNDERGONE GASTRIC BYPASS SURGERY UAB HOSPITAL, BIRMINGHAM, AL Broadcast June 20, 2005 00:00:14:00 Over the next hour, surgeons at UAB Hospital at the University
More informationLipoabdominoplasty: 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 informationClinical Policy Title: Abdominoplasty, panniculectomy and brachioplasty
Clinical Policy Title: Abdominoplasty, panniculectomy and brachioplasty Clinical Policy Number: 18.03.03 Effective Date: July 1, 2016 Initial Review Date: April 27, 2016 Most Recent Review Date: April
More informationReduction 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 informationBraLineBackLift A Safe, Reliable, and Effective Method for Achieving Dramatic Results for Comprehensive Back Contouring
1 2 3 4 5 6 7 8 9 BraLineBackLift A Safe, Reliable, and Effective Method for Achieving Dramatic Results for Comprehensive Back Contouring Q2Q3 Joseph P. Hunstad, MD*, Phillip D. Khan, MD 10 Q4 11 12 KEYWORDS
More informationTummy 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 informationAnti-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 informationPrognostication for Body Contouring Surgery After Bariatric Surgery
Prognostication for Body Contouring Surgery After Bariatric Surgery Devinder Singh, MD, a Antonio J. V. Forte, MD, b Hamid R. Zahiri, DO, a Lindsay E. Janes, BS, a Jennifer Sabino, MD, a Jamil A. Matthews,
More informationBODY CONTOURING SURGERY AFTER MASSIVE WEIGHT LOSS
BODY CONTOURING SURGERY AFTER MASSIVE WEIGHT LOSS The purpose of this information sheet is to provide you with additional written information about body contouring surgery procedures that Dr. Lundquist
More information4/30/2010. 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 informationClinical 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 informationNo 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 informationDrains 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 informationSuperior 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 informationNo 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 information4 Abdominoplasty History and Techniques
Chapter 4 4 Abdominoplasty History and Techniques Sid Mirrafati 4.1 Introduction Numerous papers and articles have been written about the different techniques of the abdominoplasty procedureanddatebackfromoveracenturyago.body
More informationAbdominoplasty with Scarpa s Fascia Advancement Flap to Enhance the Waistline
My Way Abdominoplasty with Scarpa s Fascia Advancement Flap to Enhance the Waistline Aesthetic Surgery Journal 2016, Vol 36(7) 852 857 2016 The American Society for Aesthetic Plastic Surgery, Inc. Reprints
More informationBody Contouring After Major Weight Loss
Body Contouring After Major Weight Loss Dramatic weight loss, whether achieved by proper nutrition and exercise, or as the result of bariatric surgery, or from other forms of medical treatment, has many
More informationWe 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 informationPatient 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 informationKenneth 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 informationThe 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 informationDeep-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 informationVarious Surgical Techniques for Improving Body Contour
Aesth. Plast. Surg. 29:446 455, 2005 DOI: 10.1007/s00266-005-0037-9 Various Surgical Techniques for Improving Body Contour La zaro Ca rdenas-camarena, M.D. Jalisco, Me xico Abstract. Body contouring surgery
More informationMICHAEL 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 informationClinical Policy Title: Body contouring surgery after massive weight loss
Clinical Policy Title: Body contouring surgery after massive weight loss Clinical Policy Number: 18.03.03 Effective Date: July 1, 2016 Initial Review Date: April 27, 2016 Most Recent Review Date: April
More informationF ORUM. Does Lipoplasty Really Add Morbidity to Abdominoplasty? Revisiting the Controversy With a Series of 406 Cases
Does Lipoplasty Really Add Morbidity to Abdominoplasty? Revisiting the Controversy With a Series of 406 Cases W. Grant Stevens, MD; Robert Cohen, MD; Steven D. Vath, MD; David A. Stoker, MD; and Elliot
More informationDespite 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 informationNo 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 informationPost-bariatric body contouring: our experience
Acta Biomed 2016; Vol. 87, N. 1: 70-75 Mattioli 1885 Original article Post-bariatric body contouring: our experience Michele P. Grieco 1, Eugenio Grignaffini 1, Francesco Simonacci 1, Donatello Di Mascio
More informationClinical Study Panniculectomy Combined with Bariatric Surgery by Laparotomy: An Analysis of 325 Cases
Surgery Research and Practice Volume 2015, Article ID 193670, 10 pages http://dx.doi.org/10.1155/2015/193670 Clinical Study Panniculectomy Combined with Bariatric Surgery by Laparotomy: An Analysis of
More informationWaist 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 informationFrom ancient times to the present day, the aesthetic female breast has been portrayed. A Classification and Algorithm for Treatment of Breast Ptosis
lassification and lgorithm for Treatment of reast Ptosis Laurence Kirwan, M ackground: The Regnault classification of breast ptosis is insufficient for determining surgical strategies for different stages
More informationAnatomical 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 informationAbdominoplasty 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 informationThe question Which face lift technique is COSMETIC. A Comparison of Face Lift Techniques in Eight Consecutive Sets of Identical Twins
COSMETIC A Comparison of Face Lift Techniques in Eight Consecutive Sets of Identical Twins Darrick E. Antell, M.D., D.D.S. Michael J. Orseck, M.D. New York, N.Y. Background: Selecting the correct face
More informationInternational 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 informationSee Before & After Gallery and Other Procedures at Open Body Contour
Open Body Contour Despite the great advances which have been achieved since the advent of suction lipoplasty, surgeons and patients are still unable to restore skin elasticity. Skin becomes loose for several
More informationOur Experience with Endoscopic Brow Lifts
Aesth. Plast. Surg. 24:90 96, 2000 DOI: 10.1007/s002660010017 2000 Springer-Verlag New York Inc. Our Experience with Endoscopic Brow Lifts Ozan Sozer, M.D., and Thomas M. Biggs, M.D. İstanbul, Turkey and
More informationPostoperative Surgical Site Infection after Incisional Hernia Repair: Link to Previous Surgical Site Infection? Zulfiqar Ali, AG Rehan
Original Article Postoperative Surgical Site Infection after Incisional Hernia Repair: Link to Previous Surgical Site Infection? Zulfiqar Ali, AG Rehan ABSTRACT Objective: Aim of the study was to determine
More informationComponents 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 informationThe aesthetic correction of abdominal deformities. Ideas and Innovations
Ideas and Innovations Long-Term Ultrasonographic Evaluation of Midline Aponeurotic Plication during Abdominoplasty Eduardo José Passamai de Castro Henrique N. Radwanski, M.D. Ivo Pitanguy, M.D., Ph.D.
More informationThe Desire for Body Contouring Surgery after Bariatric Surgery
OBES SURG (8) 18:18 1312 DOI.7/s11695-8-9557- RESEARCH ARTICLE The Desire for Body Contouring Surgery after Bariatric Surgery James E. Mitchell & Ross D. Crosby & Troy W. Ertelt & Joanna M. Marino & David
More information11. I realize that not having the operation is an option.
Consent Body Lift Surgery 1. I hereby authorize Dr. John P. Stratis and such assistants as may be selected to perform the following procedure or treatment. BODY LIFT (Circumferential abdominoplasty, lower
More informationCase 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 informationINFORMED-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 informationALTERNATIVE 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 informationINCISIONAL HERNIAS. Contents What is an Incisional Hernia?... 3
Contents What is an Incisional Hernia?................... 3 When can I return to normal activities?....... 6 YOUR GUIDE TO INCISIONAL HERNIAS An IPRS Guide to provide you with exercises and advice to ease
More informationThe Tumescent Technique TUMESCENT TECHNIQUE. by itself We strongly recommend that you consult with one of our nutrition and
procedures. Body sculpting can be performed on virtually any area of the body. If there is a body area of concern not mentioned, please ask specifically about these areas at the time of consultation. The
More informationJPRAS 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 informationINFORMED CONSENT BODY LIFT SURGERY
INSTRUCTIONS This is an informed-consent document that has been prepared to help inform you concerning body lift surgery (also commonly called lower body lift, belt lipectomy, circumferential lipectomy,
More informationBarbed 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 informationMethods of autologous tissue breast reconstruction BREAST
BREAST Comparison of Donor-Site Morbidity of SIEA, DIEP, and Muscle-Sparing TRAM Flaps for Breast Reconstruction Liza C. Wu, M.D. Anureet Bajaj, M.D. David W. Chang, M.D. Pierre M. Chevray, M.D., Ph.D.
More informationAesthetic surgery techniques after excision of dermatofibrosarcoma protuberans: a case report
British Journal of Plastic Surgery (2005) 58, 556 560 CASE REPORT Aesthetic surgery techniques after excision of dermatofibrosarcoma protuberans: a case report G. Dagregorio a, *, V. Darsonval b a Department
More informationDr. James B. Lowe Plastic Surgery BODY CONTOURING SURGERY INFORMATION SHEET AND INFORMED CONSENT
Dr. James B. Lowe Plastic Surgery BODY CONTOURING SURGERY INFORMATION SHEET AND INFORMED CONSENT Instructions This is an informed consent document that has been prepared to assist your plastic surgeon
More informationThe 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 informationINFORMED-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 informationThe Profunda Artery Perforator Flap: Investigating the Perforasome Using Three-Dimensional Computed Tomographic Angiography
BREAST The Profunda Artery Perforator Flap: Investigating the Perforasome Using Three-Dimensional Computed Tomographic Angiography Corrine Wong, M.D. Purushottam Nagarkar, M.D. Sumeet Teotia, M.D. Nicholas
More informationProgressive 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 informationINFORMED CONSENT-BREAST RECONSTRUCTION WITH TRAM ABDOMINAL MUSCLE FLAP
INFORMED CONSENT-BREAST RECONSTRUCTION WITH TRAM ABDOMINAL MUSCLE FLAP 2000 American Society of Plastic Surgeons. Purchasers of the Patient Consultation Resource Book are given a limited license to modify
More informationINCISIONAL HERNIA REPAIR A CLINICAL STUDY OF 30 PATIENTS
IJCRR Vol 05 issue 15 Section: Healthcare Category: Research Received on: 09/07/13 Revised on: 28/07/13 Accepted on: 11/08/13 INCISIONAL HERNIA REPAIR A CLINICAL STUDY OF 30 PATIENTS Nikhil Nanjappa B.
More informationIntraabdominal Pressure in Abdominoplasty Patients
Aesth. Plast. Surg. 30:655 658, 2006 DOI: 10.1007/s00266-004-5026-x Intraabdominal Pressure in Abdominoplasty Patients Lincoln Grac a Neto, M.D., M.Sc., Luiz Roberto Arau jo, M.D., M.Sc., Marcelo Roberto
More information