The Reverse Abdominoplasty

Abstract

To date, the reverse abdominoplasty has been reported infrequently as a procedure to improve the upper abdominal wall contour. In this report, we report on our experience with the reverse abdominoplasty and on a review of the English-language literature by using PubMed to draw conclusions regarding optimal indication for this procedure, results, and complications. Over a 3-year period, we have performed the reverse abdominoplasty in 7 patients that were all dissatisfied with their upper abdominal contour after previous abdominal wall contouring procedures. Five patients had preexisting submammary scars. The mean follow-up was 20 months (range 9-29 months). In all but one patient there was a significant improvement of the upper abdominal wall contour. The esthetic result as measured with the Strasser grading system was good in 4 cases, mediocre in 2 cases, and poor in 1 case. The mean patient's satisfaction was 6.3 (range 1-10) as measured on a Visual Analog Scale. In 3 patients there were complications: in 2 patients a minor complication (wound dehiscence and a small seroma) and in 1 patient a more severe complication (wound dehiscence with ultimately sagging of scars and submammary sulcus) with a poor esthetic final result. In the English-language literature the reverse abdominoplasty procedure has been reported infrequently both for purely esthetic reasons and for reconstructive reasons with good results and few complications. Based upon our results and those as reported in the English-language literature, we conclude that there is a clear though limited indication for the reverse abdominoplasty procedure in a selected group of patients: redundant upper abdominal wall tissue after a previous abdominoplasty or liposuction, preferably with preexistent submammary scars.