Every operation for body contouring must be individualized. There will never be one standard' procedure that is optimal for every woman. It is important to select a plastic surgeon that is competent in al forms of body contouring. It is with this experience, knowing what works in each situation, that the best results can be achieved. The blending of liposuction with a traditional abdominoplasty has been a growing trend in body contouring. This method combines the best qualities of each technique to achieve an outstanding result. This technique was developed in Brazil . The procedure
starts with liposuction of the abdomen both above and below the umbilicus as well as the flanks. A traditional low bikini incision is made and the extra or redundant skin below the umbilicus is freed up and removed. Above the umbilicus great care is used to avoid the blood vessels that nourish this region. Limited actual undermining of the skin is done in some much as there is sufficient space to perform a muscle repair in the midline. On the properly selected patient this can result in a nice tapered waistline and abdominal contour.
The operation begins with a careful and thorough pre-operative examination. The quality of the skin and fat must be assessed along with the distribution of fat and the degree of elasticity of the abdominal wall. The fat should be a good quality, soft and pliable. Thickened or fibrous fat will not liposuction well and the overlying skin usually does not shrink down well. The location and length of the needed incision is most easily assessed from the sitting position and then transferred to the abdominal skin. The incision is placed in a transverse direction across the hips just above the pubic bone. It is important that the incision is placed in a location that can be easily covered when the patient has on a bathing suit or other garment. It is common to ask the patient to wear what every bathing suit bottom or underwear that she will want to use after the procedure to be certain that the scar can be adequately covered. The operation is planned with a combination of liposuction and traditional surgery. Liposuction is frequently performed first in the areas above and below the umbilicus and on the flanks. Once the incision is made the skin is lifted up from the underlying muscles giving the necessary exposure for a double layered suture repair of the abdominal wall. The dissection above the umbilicus is in a narrow V only undermining enough to give access to the muscle repair. Then the skin is stretched tight over the newly remodeled abdominal wall and pulled down like a vest over your pants. The extra skin is removed and contoured. The surgeon then creates a new spot for the umbilicus. Great care is used to create an umbilicus that is not only in the correct position but is youthfully contoured. The final step is liposuction contouring of the rest of the abdomen including the posterior hips and upper back.
The major difference between the standard abdominoplasty and lipoabdominoplasty is a process known as discontinuous undermining. In other words the liposuction cannula is used to perform much of the dissection. This allows these all important blood vessels to be pushed aside and not cut. This ensures a better blood supply thus reducing complications due to insufficient circulation. Another advantage is the sparing of sensory nerves allowing for a more normal return of sensation. The result is that patients of Lipoabdominoplasty patients are left with an improved ability to heal since more of the blood circulation is preserved. It only makes sense that the more attention placed to maintenance of adequate blood flow and tissue oxygenation the better the overall healing. All patients, of course, can expect some swelling, bruising and pain following a lipoabdominoplasty. The final result will be a contoured, aesthetically pleasing result that should meet all expectations. .
Finding an experienced and board certified plastic surgeon is important when considering any body contouring procedure. Dr. Zwiren and Dr. Nakano of Prima Center for Plastic Surgery are experienced in all forms of body contouring, liposuction, lipoabdominoplasty and abdominoplasty both aesthetic and reconstructive.
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