Abdominoplasty without panniculus undermining and resection: Analysis and 3-year follow-up of 97 consecutive cases

Abstract

Background: Traditional abdominoplasty, with or without lipoplasty, can achieve pleasing aesthetic results is associated with serious postoperative complications. Objective: We describe an abdominoplasty procedure that combines resection of excess skin with lipoplasty but without panniculus undermining or resection. Methods: The redundant pannus was marked, and the dermis in this region was resected, but the underlying subcutaneous fat, connective tissues, and all vessels were preserved. Lipoplasty of the abdominal wall was performed at a plane below Scarpa's fascia, allowing the cutaneous and subcutaneous panniculus to slide over the muscular aponeurotic wall while preserving all perforating vessels as multiple pedicles. If appropriate, plication of the aponeurotic structures was performed through a star-shaped incision in the umbilical region. Results: We achieved excellent improvement of body contour with fewer complications and less discomfort to the patient compared with traditional abdominoplasty procedures. Conclusions: Abdominoplasty without panniculus undermining enables treatment of localized adiposity and excess abdominal wall skin as well as reinforcement of the muscular aponeurotic structures while significantly reducing the risk of seroma formation and other complications. The technique is not indicated for cases where complex reconstruction of the abdominal aponeurotic wall is necessary.