The suprapubic deepithelialized inferiorly based random flap designed to fill the tissue deficiency at supraumbilical area to prevent the concave deformity in abdominoplasty

Abstract

<br><b>Introduction:</b> The most critical tissue in abdominoplasty is the midsagittal part of the supraumbilical region with the highest risk of hemodynamic disturbance. Here, the skin is also thinner compared to the neighboring lateral tissues. This may result in postoperative suprapubic depression. <b>Methods:</b> An easy technique is designed to prevent this suprapubic depression. While making the transverse incision, deepithelialized suprapubic flap is kept in place attached to the suprapubic region. The medial supraumbilical deficient tissue is brought down with the abdominoplasty flap and lowered over the deepithelialized suprapubic flap. <b>Results:</b> Follow-up with the patients is between 1 month and 2 years. We have no longer observed any concave deformity. <b>Discussion:</b> Another technique described in the literature designed to prevent the concave deformity is deepithelization of the tongue of tissue projecting from the lower end of the abdominal flap and folding this back to double up the thickness of fat in this area. Nevertheless, the median distal end of the abdominal flap is hemodynamically the poorest part of the flap. Preparing deepithelialized tongue and folding it back raises the vascular insufficiency risk. Suturing the upper edge and the sides of the supraumbilical flap to deep tissues of the abdominal flap distribute the tissue tension to deeper parts, thus reduce the incision tension with reduced scar tension at the midline. <b>Conclusion:</b> The suprapubic random flap is an assurance for prevention of concave deformity and helps to reduce the tension of transverse incision at the midline, thus may reduce the risk of scar formation.<br>