Abdominal Plastic Surgery and Adjunctive Procedures

Abstract

Complex abdominal wall reconstruction often requires adjunctive procedures to ensure not only functional outcomes, but also better aesthetic body contour and shape. These procedures should be mastered by the operating general surgeon or should be referred to the plastic surgeon. In this chapter we will describe some of these adjunct procedures such as liposuction alone; lipoabdominoplasty; miniabdominoplasty; full abdominoplasty; or even superior or reverse abdominoplasty. Miniabdominoplasty employs the use of umbilical float technique to allow a scarless movement of the umbilicus inferiorly by about 2 cm while simultaneously plicating the fascia; however, this technique limits the skin excision significantly. Full abdominoplasty with extended scar allows multiplanar application of all modalities while removing the maximal skin by extending the scars to the flanks which minimize the chance of formation of “dog ears.” Superior or reverse abdominoplasty involves the excision of excess skin of the superior aspect of the abdominal wall and is usually performed on patients who also desire reduction, mastopexy, and/or augmentation via the same inframammary incisions. Next, we will discuss abdominal surgery after massive weight loss which requires extensive peri-operative management and planning in addition to flawless execution of this complex procedure in order to obtain excellent outcomes. Finally, we will examine the latest evidence based literature on avoidance and management of complications from abdominal plastic surgery operations.