Anchor-Line Abdominoplasty: A Comprehensive Approach to Abdominal Wall Reconstruction and Body Contouring

Abstract

Classic abdominoplasty leads to disappointing aesthetic results in patients with preexisting supraumbilical scars. Various techniques involving vertical and horizontal incisions have been described. The authors point out the validity of the "anchor-line" approach. In a retrospective study, the authors reviewed the charts of 42 patients who underwent an anchor-line abdominoplasty between March of 1997 and March of 2003 at the Campus Bio-Medico University in Rome. The vascular anatomy of the abdominal wall was carefully reviewed, and they reported Huger's classification into three zones (zones I, II, and III). The third zone, which corresponds to the lateral areas of the abdomen, provides the vascular supply to the undermined abdominal wall flaps. Whenever this lateral vascularization is spared, there is no risk of skin necrosis. The anchor-line abdominoplasty implies the en bloc resection of a lower horizontal ellipsis plus an upper vertical triangle of abdominal skin and subcutaneous fat. The vertical triangle entails the supraumbilical scars. Plication of the rectus muscle sheath is always carried out. Follow-up ranged from 1 to 5 years. The following complications were seen: seroma (n = 3), anemia (n = 2), infection (n = 1), and minor skin necrosis (n = 1). The anchor-line technique, because of its easy execution, is a valid procedure in candidates for an abdominoplasty with supraumbilical median or paramedian scars.