Technical Considerations in Abdominoplasty of Huge Abdomen

Abstract

In abdominoplasty, the surgeon aims to contour the abdominal wall and create a balanced relationship with the lower body contour. The condition huge abdomen is characterized by severe lipohypertrophy; marked laxity of the abdominal skin, which almost overlaps the mons pubis and upper thighs; divarication of the recti; and ptosis of the mons pubis. Abdominoplasty of huge abdomen carries a higher risk of postoperative complications and unaesthetic results. This study presents certain technical considerations in liposuction: preservation of the vascular perforators and subumbilical scarpa fascia, undermining/resection of the abdominal skin, performance of umbilicoplasty, and lifting of the mons pubis. From June 2009 to June 2011, abdominoplasty were performed on 112 patients with the condition huge abdomen. Body weights ranged from 89 to 105 kg, with a mean of 92 kg. Body mass index ranged from 32.7 to 37.4, with a mean of 35.2. After an average follow-up period of 1 year, 93 patients (83%) achieved good aesthetic results and had no major or local postoperative complications. In 4 patients (3.6%), seroma was an early postoperative complication. Six patients (5.4%) developed long-term unfavorable aesthetic results, which required secondary revisions. This study focuses on certain type of abdominal wall obesity that requires abdominoplasty and provides some technical considerations to achieve a safe and aesthetic outcome.