Traditional abdominoplasty versus dual-plane abdominoplasty in abdominal contouring

Abstract

Objectives The study aims to evaluate the effect of Scarpa's fascia preservation on the results and complications of abdominoplasty through a prospective randomized comparative study between the dual-plane and traditional abdominoplasty. Patients and methods The current study included 40 cases with redundant and/or bulged abdomen seeking abdominoplasty. Their ages ranged between 25 and 50 years, and BMI ranged from 25 to 35. BMI above 35, previous abdominal surgery, any associated hernias, postbariatric surgery, smokers, and comorbid diseases such as diabetes, chronic obstructive airway disease, and autoimmune, liver, and renal diseases were excluded. Results With Scarpa's fascia preservation, the mean total drain output in the dual plane (175.5±35.9 ml) was much lesser than the classic abdominoplasty (479.5±177.27 ml); moreover, drains were removed earlier with Scarpa's fascia preservation (2.9±0.31 days) in comparison with classical abdominoplasty (5.5±1.92 days). All patients passed without seroma formation in Scarpa's fascia preservation in group B; however, full-thickness infraumbilical necrosis in zone I occurred in a single case (5%) and hypertrophic scar in two (10%) cases. In classic abdominoplasty (group A), seroma was detected in a single case (5%), umbilical stenosis in a single case (5%), a single case (5%) presented with full-thickness infraumbilical necrosis in zone I, and a single case (5%) developed hypertrophic scar. Conclusion Preservation of Scarpa's fascia during dual-plane abdominoplasty reduces patient recovery in the form of reducing total drain output, time for drain removal, and hospital stays in comparison with traditional abdominoplasty. Its disadvantages include longer operative time and incompatibility when mesh reinforcement of the abdominal wall is needed.