Educational Background
Santa Maria Central Hospital Lisbon Portugal
Work Experience
Plastic Surgeon since 2008
Topic: Lipo Tummytuck – Tricks to Prevent Flap Necrosis
Abstract:
Introduction
Abdominoplasty is one of the most common surgeries for women after pregnancies, aged 35 and up.
Traditionally no or little liposuction of the flap is done, except eventually only a lipodefinition of the flanks.
Our objective is to show how thorough liposuctioning the flap, can be a very safe procedure, but with
some important tricks. Its performed together with a circunferencial liposuction, with or without buttock
fat augmentation, according to the case.
Materials and methods
The author presents his experience and journey in circumferential lipotummytuck throughout the last 11
years (over 500 cases), focusing on the avoidance of flap necrosis after extensive liposuction.
The anatomy knowledge and the awareness of the angiossomes are fundamental in understanding
abdominal wall vascularization and its importance in avoiding flap necrosis
We present two types of Lipo TummyTuck in terms of perforator preservation and consequent abdominis
muscle plication aproach
Preservation of central and lateral abdominal artery perforators, allows thorough liposuction but with a
narrow tunnel, being the result limited to individuals with less muscle flaccidity and buldge.
Preserving only paramedian lateral, intercostal and lumbar perforator and their branches (Huger zone
3), with the same degree of liposuction, allows for a bigger undermining, permiting more advanced
waistline definition
Vascular preservation decision is based uppon intra op thermography and intra op flap bleeding, leading
to a stop in further liposuction or continuing it.
Results
Clinical cases, intra op photos and videos are presented and discussed as well as complications
Discussion
Very few patients have an indication for a normal abdominoplasty, without liposuction of the flap, and
therefore its mandatory to master lipoabdominoplasty. Complication rate can be high if proper care is not
taken.
Our series demonstrate how this advanced body contouring surgery can be done safely.
