U-M Abdominoplasty

Abstract

Background: Standard abdominoplasty incisions invade aesthetic units outside of the abdominal wall. Contemporary styles of body exposure and bathing suit designs demand that those incisions be hidden inside the “bikini line.” Objectives: The “U-M” abdominoplasty design meets these and other aesthetic requirements. Methods: The patient is marked in the standing position for the U-M incisions, areas of suction-assisted lipoplasty (SAL), and undermining. The lower incision is designed as an open U, with its lateral limbs placed inside and parallel to the bikini line. The upper incision is a lazy M to provide lateral tension and match the length of the lower flap. Moderate tumescent solution is used to perform SAL of the waistline and iliac prominences and to create a xiphoumbilical depression. Gentle SAL of the flap is also performed avoiding the new suprapubic area. Undermining is performed to the xiphoid. Umbilical transposition and recti diastasis repair is performed according to the surgeon’s preferred technique. Closure is performed in layers with repair of Scarpa’s layer by use of nonabsorbable suture material. Results: This technique has been used in 132 patients over the past 12 years. Complications include seroma (3%), small areas of skin necrosis (2%), pseudobursa (0.7%), drain tract infection (0.7%), and deep venous thrombosis (0.7%). The rate of patient satisfaction has been very high. Conclusions: Advantages of the U-M abdominoplasty incision technique include safe contouring with SAL, high lateral tension to minimize midline problems, anterolateral thigh lifting, pubis rejuvenation, no improvisation during surgery, and incisions hidden by the bikini and located within the aesthetic units of the abdomen.