A new approach to correction of truncal redundancy after massive weight loss—The lateral thoracoabdominoplasty

Abstract

Problems after massive weight loss include residual transverse abdominal laxity, which is not well addressed by abdominoplasty or circumferential lipoplasty, and the lateral descent of the breast mound and inframammary fold, which is not well addressed by mastopexy. The authors report a new approach, the lateral thoracoabdominoplasty, that uses a concealed mid-axillary incision to simultaneously address both of these issues. Redundant tissue was resected from the lateral aspect of the trunk rather than through a traditional midline abdominal incision. The anterior abdomen was left unblemished, and the scars were concealed along the mid-axillary line from the axilla to the iliac crest. The patient had no complications after more than 1 year follow-up and was satisfied with the results. The lateral thoracoabdominoplasty effectively corrects the vertical abdominal laxity and lateral breast descent seen after massive weight loss. The procedure is intended for patients who have undergone minimally invasive bariatric surgery or lost weight by diet and exercise and thus lack an existing midline incision. It provides only limited benefits with respect to improvement of upper midline abdominal fullness.