Endoscopic Abdominoplasty

ABSTRACT

The term abdominoplasty covers a broad range of surgical procedures designed to improve abdominal wall contour. These procedures include dermolipectomy, liposuction, and musculofascial abdominal wall plication. Many attempts have been made to modify the technique to reduce scar visibility and length and to potentially decrease morbidity. In this article, the anatomy of the abdominal wall is reviewed and a classification system is developed evaluating the quality and quantity of the patient's skin, the amount of excess fat, and the musculofascial contour of the abdominal wall. With this classification system, the appropriate surgical treatment can be determined for each patient. Class 1 patients with normal to slight excess skin, a mild to moderate amount of excess fat, and normal musculofascial contour are candidates for liposuction alone. Class 2 patients with similar skin and fat, but with an abnormal musculofascial contour are ideal candidates for endoscopic rectus abdominis plication and liposuction. Class 3 patients with moderate to severe skin and fat excess, with or without an abnormal musculofascial contour, are not candidates for the endoscopic approach and require an open abdominoplasty. The operative technique of endoscopic abdominoplasty using the pubic approach, the umbilical approach, and a combination approach is described in detail.

Keywords

Abdominoplasty - endoscopic surgery