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1.
Aesthetic Plast Surg ; 43(3): 718-725, 2019 06.
Artigo em Inglês | MEDLINE | ID: mdl-30941455

RESUMO

BACKGROUND: During the last few years, the surgical principles of abdominoplasty remained unchanged. Therefore, many observed results have misaligned, high and straight abdominal transverse scars, leading to the final positioning of the umbilical scar to be very close to the transverse scar, which gives the impression of a short abdomen. We propose that the abdominoplasty should change the basic conception of its marking, because we believe that it is important to place the transverse scar lower in the medial and pubic region, and higher in the lateral extremities, thus allowing a rotation of the flap of the anterior flanks back lumbar in the median inferior direction. MATERIALS: We analyzed 136 patients with abdominal deformities and subjected them to lipomid-abdominoplasty making a marking with strong upper concavity and lateral sides of the scar oriented to the lower transverse line of the abdomen, 4 cm equidistant from the root of the thigh. We also associate liposuction as a complementary treatment to body contouring. CONCLUSIONS: It is important to determine the area of the abdominal deformity and its classification, to establish the strategies of treatment, and association of complementary procedures. A lower marking respecting the treatment areas will allow a better esthetic scar and a harmonic body contour as well as an adequate placement of the elements: umbilical scar, pubis and lateral extremities of transverse abdominal scar. LEVEL OF EVIDENCE IV: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .


Assuntos
Abdominoplastia/métodos , Contorno Corporal/métodos , Adulto , Cicatriz , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos
2.
Aesthetic Plast Surg ; 42(4): 1039-1049, 2018 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-29464382

RESUMO

BACKGROUND: Abdominoplasty is the most frequently performed surgical procedure for body contour; in our experience, we have observed some patients with prominent bulging that is difficult to treat and that presents results that are unsatisfactory or have recurrences to conventional treatments. This leads us to carry out an analysis of the elements responsible for the containment and abdominal format. We determined that it may be due to an inability of an important sagging aponeurotic muscle of primary origin to support the abdomen and could be caused by predisposing factors. For these specific cases, we developed a treatment proposing the use of a mesh. METHODS: We present these cases over a period of 24 years. Fourteen patients were treated with primary and secondary abdominoplasties. The abdominal wall reinforcement was performed by placing polypropylene mesh at the sub-muscular plane, fixed with U-stitches on the fascia transversalis, seeking to strengthen the muscle and the fascia transversalis. RESULTS: The results were satisfactory after long-term observation, gaining resolution of the abdominal bulges. Only two complications occurred; the presence of localized chronic pain and the appearance of umbilical fistula. DISCUSSION: We emphasize the importance of avoiding unnecessary interventions in patients with marked bulging, associated with inability of abdominal restraint. We only consider its indications in patients with conventional recurrence treatment, also identifying the predisposing factors, the knowledge of the abdominal anatomy, the muscular dynamics of the abdomen and understanding its indication in these specific cases of difficult treatment. LEVEL OF EVIDENCE IV: This journal requires that authors assign a level of evidence to each article. For a full description of these evidence-based medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .


Assuntos
Músculos Abdominais/cirurgia , Abdominoplastia/instrumentação , Abdominoplastia/métodos , Telas Cirúrgicas , Parede Abdominal/cirurgia , Adulto , Idoso , Aponeurose , Feminino , Humanos , Pessoa de Meia-Idade
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