Instant identification of redundant tissue in abdominoplasty with a marking grid.

Abstract

It is generally believed that continuous or discontinuous undermining of an abdominoplasty flap is necessary for its advancement, but it is also recognized that such undermining may increase the risk of ischemic complications. The author describes a grid-marking system to quickly identify the redundant tissue in abdominoplasty, making the procedure simpler, safer, and more consistent. A standardized grid was preoperatively marked on 35 consecutive female abdominoplasty patients to determine the exact pattern and extent of skin resection at the beginning of the procedure. This allowed resection of redundant tissue while confining proximal flap undermining to the minimum amount necessary for diastasis repair and umbilical repositioning. The 35 patients who underwent abdominoplasty with the author's technique were followed from three months to 2.5 years. Of these, 12 underwent simultaneous liposuction. All procedures were performed on an outpatient basis under general anesthesia in an accredited office operating facility. Overall results were excellent, with no flap ischemia or other complications directly related to wound tension or to limited undermining. A standardized grid system allows identification of redundant abdominoplasty tissue before any incisions are made, which limits undermining to the area over the medial rectus abdominis muscles, the minimum amount necessary for diastasis repair and umbilical repositioning. Simultaneous liposuction can be performed with relative safety, although it is not required for flap advancement.