Abdominoplasty Dubai

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Abdominoplasty Dubai

• By Dr. Luiz toledo

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PROBLEM

• Pregnancy (commonest)
• Massive weight loss
• Weight gain due to aging
• Bariatric surgery
• Stretch beyond capability to retract -gt skin
  thinning and loss of elasticity -gt striae,
  rectus muscle diastasis

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ANATOMY
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ANATOMY
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HISTORY

• Frequency of exercise
• GI, cardiac, pulmonary hisatory
• Smoking history
• Previous liposuction
• Future pregnancy plans

• Weight history
• BMI
• Weight fluctuations and constancy
• Bariatric procedures
• Nutritional disorders Medications
• Number of pregnancies and
• children
• History of c-section, abdominal surgeries
• History of hernias

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EXAMINATION

• Quality of Skin and pinch
• Measurement of s/c layer thickness
• Striae
• Eczema and hyperpigmentation at fold areas
• Skin excess at lower, lateral, upper abdomen,
  thighs, waist, hips and lower chest in supine,
  standing and sitting
• Scar marks
• Abd0minal wall for bulging due to rectus
• diastasis, hernias

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EXAMINATION

• Divers test
• Location and number of folds
• Measurements
• from umbilicus to top of mons
• from umbilicus to sternal notch
• from anterior vulva commissure to top of mons
• Waist and hip measurement, waist-to-hip ratio
• Thickness of abdominal adipose tissue by pinching

11-13cm
5-7cm
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PHOTGRAPHS

• Anterior
• Oblique anterior
• Side
• Oblique posterior
• Posterior views
• Additional Forward bending side and front,
  sitting

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GENDER DIFFERENCE
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TECHNIQUES

• Minimal moderate fat, no abdominal wall laxity
  - Liposuction
• Abdominal wall laxity, minimal excess skin infra
  umbilical region - Mini abdominoplasty
• Supra and infra umbilical skin laxity limited to
  the anterior region - full abdominoplasty
• Lateral and posterior skin laxity -
  circumferential lipectomy

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MINI ABDOMINOPLASTY

• Young women, 1 or 2 pregnancies
• Infra umbilical wall laxity, minimal skin and
  fat excess, good skin elasticity, not overweight
• Markings along the suprapubic crease angled
  towards ASIS
• At least 9 cm btw umbilicus and upper resection
  to avoid unaesthetic appearance

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MINI ABDOMINOPLASTY

• Infra umbilical single/two layer rectus plication
• Drains and compression garments

Dog ears
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ABDOMINOPLASTY

• Supra and infra umbilical laxity, anterior
  aspect
• Rectus diastasis of the entire length
• Patients with excess intra abdominal fat, not
  good candidates
• Marking Suprapubic crease incision, not
  extending beyond ASIS
• Flex at waist Pinch technique
• Superior incision just above the umbilicus

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ABDOMINOPLASTY

• Circumumbilical incision, umbilical stalk
  dissection to the deep fascia
• Flap elevated till xiphoid, costal margins
• Wide undermining
• Rectus plication
• Abdominal flap approximation
• Neo umbilicus created, vertical incision, 3
• point fixation (3,6,9)
• Scarpas fascia level elevation

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CIRCUMFERENTIAL LIPECTOMY

• Excess fat and generalized laxity with ptosis of
  the thighs, buttocks, hips and lower back
• Massive weight loss patients, women with
  moderate weight after childbirth or aging,
  normal weight patients desiring remarkable
  improvement
• Belt lipectomy centrally based procedure,
  treats lower truncal unit
• Lower body lift procedure that treat lower
  trunk and thighs as a unit.

Hanging panniculus, mons pubis ptosis, ill
defined waist, lower back rolls, hip fat excess,
lateral thigh ptosis, buttocks deformities
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BELT LIPECTOMY

• Superior located incision
• Scar at junction btw lower back and buttocks,
  visible above garments
• More waist definition, desired in women
• Zones of adherence are only disrupted
• Excellent lower trunk contour and waist
  definition
• Limited thigh lift

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LOWER BODY LIFT
Treats lower trunk and thigh as a unit scar over
the buttocks, can blunt waist line, desirable in
men zones of adherence are completely
interrupted, allows inferior thigh and knee lift
scar covered by garments excellent thigh lift
less effective waist and buttocks definition
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FLEUR-DE-LIS / T-TYPE PROCEDURES

• Adv
• Eliminates horizontal excess
• Creates more waist definition
• Decreases lateral fullness
• Disadv
• Chances of flap necrosis at T intersection
• Does not effect lateral thigh or buttock ptosis
• Greater mismatch between flap edges
• Epigastric fullness due to dog ear

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POST OP CARE

• Early ambulation
• Drains until discharge less then 30ml in 24 hrs
• Rest in flexion of 30 degrees for 2-3 weeks
• Shower after drain removal Examination for
  Seromas Silicon patches for 3 months Avoid
  sports for 6 weeks
• Compression garments for 6 weeks Breathing
  exercises

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COMPLICATIONS

• Wound healing problems (most common)
• Wound dehiscence
• Seromas
• Toxic shock syndrome Vascular compromise
  Hematomas
• DVT / Pulmonary embolism
• Psychiatric illness
• Scar and contour irregularities

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