Kanjoor J R, Singh A K
Consultant Plastic Surgeon, Roys Cosmetic Surgery Center, 9, Ramasamy Layout, Velandipalyam Post, Coimbatore, Tamil Nadu - 641025, India and Canadian Medical Center, Kuwait.
Indian J Plast Surg. 2012 Jan;45(1):77-88. doi: 10.4103/0970-0358.96592.
Extensive liposuction along with limited dissection of abdominal flaps is slowly emerging as a well proven advantageous method over standard abdominoplasty.
A retrospective study analyzed 146 patients managed for the abdominal contour deformities from March 2004 to February 2010. A simple method to project the post operative outcome by rotation of a supine lateral photograph to upright posture in 46 patients prospectively has succeeded in projecting a predictable result. All patients were encouraged to practice chest physiotherapy in 'tummy tuck' position during the preoperative counseling. Aggressive liposuction of entire upper abdomen, a limited dissection in the midline, plication of diastasis of rectus whenever indicated, panniculectomy and neoumblicoplasty were done in all patients.
The patients had a mean age of 43, youngest being 29 and oldest 72 years. Majority were of normal weight (94%). Twelve were morbidly obese; 57 patients had undergone previous abdominal surgeries; 49 patients had associated hernias. Lipoabdominoplasty yielded a satisfactory result in 110 (94%) patients. The postoperative patient had a definitely less heavy harmonious abdomen with improved waistline. The complications were more with higher BMI, fat thickness of more than 7 cm and prolonged operating time when other procedures were combined.
Extensive liposuction combined with limited dissection method applied to all abdominoplasty patients yielded consistently safe, reliable and predictable aesthetic results with less complications and faster recovery. The simple photographic manipulation has helped project the postoperative outcome reliably. The preoperative chest physiotherapy in tummytuck position helped prevent chest complications.
广泛抽脂联合有限的腹部皮瓣剥离术,正逐渐成为一种经充分验证的、相较于标准腹壁成形术更具优势的方法。
一项回顾性研究分析了2004年3月至2010年2月间接受腹部轮廓畸形治疗的146例患者。对46例患者采用一种简单方法,即将仰卧位侧位照片旋转至直立姿势来预测术后效果,该方法成功预测了可预期的结果。在术前咨询过程中,鼓励所有患者在“收腹”姿势下进行胸部物理治疗。所有患者均进行了全上腹部的积极抽脂、中线有限剥离、必要时的腹直肌分离折叠术、腹壁整形术和脐再造术。
患者的平均年龄为43岁,最年轻的29岁,最年长的72岁。大多数患者体重正常(94%)。12例为病态肥胖;57例患者曾接受过腹部手术;49例患者伴有疝气。抽脂腹壁成形术使110例(94%)患者获得了满意的效果。术后患者的腹部明显变轻且更协调,腰围有所改善。并发症在BMI较高、脂肪厚度超过7厘米以及联合其他手术导致手术时间延长的情况下更多。
广泛抽脂联合有限剥离方法应用于所有腹壁成形术患者,能持续产生安全、可靠且可预测的美学效果,并发症更少且恢复更快。简单的照片处理有助于可靠地预测术后效果。术前在收腹姿势下进行胸部物理治疗有助于预防胸部并发症。