9903-1020 Shestak
Shestak KC.
Marriage abdominoplasty expands the mini-abdominoplasty concept.
Plast Reconstr Surg. 1999 Mar;103(3):1020-31; discussion 1032-5. PMID: 10077098
Magee-Women's Hospital, Department of Surgery, University of Pittsburgh School
of Medicine, PA 15213, USA.
The marriage of aggressive superwet liposculpture of the abdomen and adjacent
anatomic regions with a modification of well-established open surgical
techniques to address skin excess and perform muscle plication was used to treat
29 patients presenting for aesthetic abdominal contouring over the past 3 1/2
years. The charts of 57 patients who had aesthetic contouring procedures on the
abdomen performed from December of 1994 to July of 1998 were retrospectively
reviewed. Fifteen patients underwent suction lipectomy alone, 13 patients were
treated with conventional abdominoplasty, and 29 underwent "marriage
abdominoplasty." The 29 patients who underwent marriage abdominoplasty presented
with deformities marked by excess lower abdominal skin and adipose tissue, with
or without muscle laxity (Psillakis types II, III, and IV). Seventeen procedures
were performed under local anesthesia with deep conscious sedation on an
outpatient surgical basis. In 12 patients, the operation accompanied a
hysterectomy, urologic procedure, or additional aesthetic surgical procedure(s)
and was done under general anesthesia. Suction aspirates ranged between 540 and
2600 cc (mean, 1160 cc) and were accompanied by lower abdominal skin excision in
every case, which was performed predominantly through short and medium-length
incisions (mean, 15 cm). Rectus abdominis muscle plication was performed where
necessary, using vertical plication of the infraumbilical rectus muscles in 27
patients (93 percent) and full-length plication in two patients (7 percent). All
patients demonstrated significantly improved contours and have seemed to
manifest less pain when compared with patients treated by full traditional
abdominoplasty. Postoperative complications have included upper abdominal skin
waviness (2), annoying paresthesias and discomfort persisting for 6 months (1),
seroma (1), and marginal skin necrosis with an open wound (1). The latter
problem occurred in the only patient who was treated with a revision procedure.
Thus, the complication rate was 17 percent (5 of 29 patients). The marriage of
aggressive superwet liposculpture of the entire abdomen with standard open
surgical techniques used to treat skin excesses and allow abdominal muscle
plication where necessary offers the advantage of reduced surgery when compared
with full abdominoplasty, while consistently achieving significant contour
improvement. This concept is applicable to the majority of patients presenting
for the treatment of abdominal deformities and has markedly expanded the
application of the mini-abdominoplasty concept.
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