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Abdominoplasty Dubai
BY DR. LUIZ TOLEDO
PROBLEM
 Pregnancy (commonest)
 Massive weight loss
 Weight gain due to aging
 Bariatric surgery
Stretch beyond capability to
retract -> skin thinning and loss
of elasticity -> striae, rectus
muscle diastasis
ANATOMY
ANATOMY
HISTORY
 Weight history
 BMI
 Weight fluctuations and constancy
 Bariatric procedures
 Nutritional disorders
Medications
 Number of pregnancies and
 children
 History of c-section, abdominal
surgeries
 History of hernias
 Frequency of exercise
 GI, cardiac, pulmonary hisatory
 Smoking history
 Previous liposuction
 Future pregnancy plans
EXAMINATION
• Quality of Skin and pinch
• Measurement of s/c layer thickness
• Striae
• Eczema and hyperpigmentation at fold areas
• Skin excess at lower, lateral, upper abdomen, thighs,
waist, hips and lower chest in supine, standing and sitting
• Scar marks
• Abd0minal wall for bulging due to rectus
diastasis, hernias
EXAMINATION
• Divers test
• Location and number of folds
• Measurements…
1. from umbilicus to top of mons
2. from umbilicus to sternal notch
3. from anterior vulva commissure to top of mons
4. Waist and hip measurement, waist-to-hip
ratio
5. Thickness of abdominal adipose tissue by
pinching
5-7cm
11-13cm
PHOTGRAPHS
 Anterior
 Oblique anterior
 Side
 Oblique posterior
Posterior views
Additional: Forward bending side and front, sitting
GENDER DIFFERENCE
TECHNIQUES
Minimal – moderate fat, no abdominal wall laxity - Liposuction
Abdominal wall laxity, minimal excess skin infra umbilical region - Mini
abdominoplasty
Supra and infra umbilical skin laxity limited to the anterior region - full
abdominoplasty
Lateral and posterior skin laxity - circumferential lipectomy
MINIABDOMINOPLASTY
• Young women, 1 or 2 pregnancies
• Infra umbilical wall laxity, minimal skin and fat
excess, good skin elasticity, not overweight
• Markings: along the suprapubic crease angled
towards ASIS
• At least 9 cm btw umbilicus and upper resection
to avoid unaesthetic appearance
MINIABDOMINOPLASTY
• Infra umbilical single/two layer rectus plication
• Drains and compression garments
• Dog ears
ABDOMINOPLASTY
 Supra and infra umbilical laxity, anterior
aspect
 Rectus diastasis of the entire length
 Patients with excess intra abdominal fat, not
good candidates
Marking: Suprapubic crease incision, not
extending beyond ASIS
Flex at waist Pinch
technique
Superior incision just above the umbilicus
ABDOMINOPLASTY
 Circumumbilical incision, umbilical stalk
dissection to the deep fascia
 Flap elevated till xiphoid, costal margins
 Wide undermining
 Rectus plication
Abdominal flap approximation
Neo umbilicus created, vertical incision, 3
point fixation (3,6,9)
Scarpa’s fascia level elevation
CIRCUMFERENTIAL LIPECTOMY
 Excess fat and generalized laxity with ptosis
of the thighs, buttocks, hips and lower back
 Massive weight loss patients, women with
moderate weight after childbirth or aging,
normal weight patients desiring remarkable
improvement
Belt lipectomy: centrally based procedure,
treats lower truncal unit
Lower body lift: procedure that treat lower
trunk and thighs as a unit.
Hanging panniculus, mons pubis
ptosis, ill defined waist, lower back
rolls, hip fat excess, lateral thigh
ptosis, buttocks deformities
BELT LIPECTOMY
 Superior located incision
 Scar at junction btw lower back and
buttocks, visible above garments
 More waist definition, desired in women
 Zones of adherence are only disrupted
Excellent lower trunk contour and waist
definition
Limited thigh lift
LOWER BODY LIFT
Treats lower trunk and thigh as a unit scar over the buttocks, can blunt waist
line, desirable in men zones of adherence are completely interrupted, allows
inferior thigh and knee lift scar covered by garments excellent thigh lift less
effective waist and buttocks definition
FLEUR-DE-LIS /T-TYPEPROCEDURES
• Adv:
1. Eliminates horizontal excess
2. Creates more waist definition
3. Decreases lateral fullness
• Disadv:
1. Chances of flap necrosis
at T intersection
2. Does not effect lateral
thigh or buttock ptosis
3. Greater mismatch between flap
edges
4. Epigastric fullness due to dog ear
POST OPCARE
 Early ambulation
 Drains until discharge less then 30ml in 24 hrs
 Rest in flexion of 30 degrees for 2-3 weeks
 Shower after drain removal Examination for
Seromas Silicon patches for 3 months Avoid
sports for 6 weeks
Compression garments for 6 weeks Breathing
exercises
COMPLICATIONS
1. Wound healing problems (most common)
2. Wound dehiscence
3. Seromas
4. Toxic shock syndrome Vascular
compromise Hematomas
DVT / Pulmonary embolism
Psychiatric illness
Scar and contour irregularities
Abdominoplasty Dubai

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Abdominoplasty Dubai

  • 2. PROBLEM  Pregnancy (commonest)  Massive weight loss  Weight gain due to aging  Bariatric surgery Stretch beyond capability to retract -> skin thinning and loss of elasticity -> striae, rectus muscle diastasis
  • 5. HISTORY  Weight history  BMI  Weight fluctuations and constancy  Bariatric procedures  Nutritional disorders Medications  Number of pregnancies and  children  History of c-section, abdominal surgeries  History of hernias  Frequency of exercise  GI, cardiac, pulmonary hisatory  Smoking history  Previous liposuction  Future pregnancy plans
  • 6. EXAMINATION • Quality of Skin and pinch • Measurement of s/c layer thickness • Striae • Eczema and hyperpigmentation at fold areas • Skin excess at lower, lateral, upper abdomen, thighs, waist, hips and lower chest in supine, standing and sitting • Scar marks • Abd0minal wall for bulging due to rectus diastasis, hernias
  • 7. EXAMINATION • Divers test • Location and number of folds • Measurements… 1. from umbilicus to top of mons 2. from umbilicus to sternal notch 3. from anterior vulva commissure to top of mons 4. Waist and hip measurement, waist-to-hip ratio 5. Thickness of abdominal adipose tissue by pinching 5-7cm 11-13cm
  • 8. PHOTGRAPHS  Anterior  Oblique anterior  Side  Oblique posterior Posterior views Additional: Forward bending side and front, sitting
  • 10. TECHNIQUES Minimal – moderate fat, no abdominal wall laxity - Liposuction Abdominal wall laxity, minimal excess skin infra umbilical region - Mini abdominoplasty Supra and infra umbilical skin laxity limited to the anterior region - full abdominoplasty Lateral and posterior skin laxity - circumferential lipectomy
  • 11. MINIABDOMINOPLASTY • Young women, 1 or 2 pregnancies • Infra umbilical wall laxity, minimal skin and fat excess, good skin elasticity, not overweight • Markings: along the suprapubic crease angled towards ASIS • At least 9 cm btw umbilicus and upper resection to avoid unaesthetic appearance
  • 12. MINIABDOMINOPLASTY • Infra umbilical single/two layer rectus plication • Drains and compression garments • Dog ears
  • 13. ABDOMINOPLASTY  Supra and infra umbilical laxity, anterior aspect  Rectus diastasis of the entire length  Patients with excess intra abdominal fat, not good candidates Marking: Suprapubic crease incision, not extending beyond ASIS Flex at waist Pinch technique Superior incision just above the umbilicus
  • 14. ABDOMINOPLASTY  Circumumbilical incision, umbilical stalk dissection to the deep fascia  Flap elevated till xiphoid, costal margins  Wide undermining  Rectus plication Abdominal flap approximation Neo umbilicus created, vertical incision, 3 point fixation (3,6,9) Scarpa’s fascia level elevation
  • 15. CIRCUMFERENTIAL LIPECTOMY  Excess fat and generalized laxity with ptosis of the thighs, buttocks, hips and lower back  Massive weight loss patients, women with moderate weight after childbirth or aging, normal weight patients desiring remarkable improvement Belt lipectomy: centrally based procedure, treats lower truncal unit Lower body lift: procedure that treat lower trunk and thighs as a unit. Hanging panniculus, mons pubis ptosis, ill defined waist, lower back rolls, hip fat excess, lateral thigh ptosis, buttocks deformities
  • 16. BELT LIPECTOMY  Superior located incision  Scar at junction btw lower back and buttocks, visible above garments  More waist definition, desired in women  Zones of adherence are only disrupted Excellent lower trunk contour and waist definition Limited thigh lift
  • 17. LOWER BODY LIFT Treats lower trunk and thigh as a unit scar over the buttocks, can blunt waist line, desirable in men zones of adherence are completely interrupted, allows inferior thigh and knee lift scar covered by garments excellent thigh lift less effective waist and buttocks definition
  • 18. FLEUR-DE-LIS /T-TYPEPROCEDURES • Adv: 1. Eliminates horizontal excess 2. Creates more waist definition 3. Decreases lateral fullness • Disadv: 1. Chances of flap necrosis at T intersection 2. Does not effect lateral thigh or buttock ptosis 3. Greater mismatch between flap edges 4. Epigastric fullness due to dog ear
  • 19. POST OPCARE  Early ambulation  Drains until discharge less then 30ml in 24 hrs  Rest in flexion of 30 degrees for 2-3 weeks  Shower after drain removal Examination for Seromas Silicon patches for 3 months Avoid sports for 6 weeks Compression garments for 6 weeks Breathing exercises
  • 20. COMPLICATIONS 1. Wound healing problems (most common) 2. Wound dehiscence 3. Seromas 4. Toxic shock syndrome Vascular compromise Hematomas DVT / Pulmonary embolism Psychiatric illness Scar and contour irregularities