Marriage abdominoplasty expands the mini-abdominoplasty concept

The marriage of aggressive superwet liposculpture of the abdomen and adjace nt anatomic regions with a modification of well-established open surgical t echniques to address skin excess and perform muscle plication was used to t reat 29 patients presenting for aesthetic abdominal contouring over the pas t 3 1/2 years. The charts of 57 patients who had aesthetic contouring procedures on the ab domen performed from December of 1994 to July of 1998 were retrospectively reviewed. Fifteen patients underwent suction lipectomy alone, 13 patients w ere treated with conventional abdominoplasty, and 29 underwent "marriage ab dominoplasty." The 29 patients who underwent marriage abdominoplasty presented with deform ities mar ked by excess lower abdominal skill and adipose tissue, with or w ithout muscle laxity (Psillakis types II, III, and IV). Seventeen procedure s were performed under local anesthesia with deep conscious sedation on an outpatient surgical basis. In 12 patients, the operation accompanied a hyst erectomy, urologic procedure, or additional aesthetic surgical procedure(s) and was done under general anesthesia. Suction aspirates ranged between 54 0 and 2000 cc (mean, 1160 cc) and were accompanied by lower abdominal skin excision in every case, which was performed predominantly through short and medium-length incisions (mean, 15 cm). Rectus abdominis muscle plication w as performed where necessary, using vertical plication of the infraumbilica l rectus muscles in 27 patients (93 percent) and full-length plication in t wo patients (7 percent). All patients demonstrated significantly improved contours and have seemed t o manifest less pain when compared with patients treated by full traditiona l abdominoplasty. Postoperative complications have included upper abdominal skirt wariness (2), annoying paresthesias and discomfort persisting for 6 months (1), seroma (1), and marginal skin necrosis with an open wound (1). The latter problem occurred in the only patient who was treated with a revi sion procedure. Thus, the complication rate was 17 percent (5 of 29 patient s). The marriage of aggressive superwet liposculpture of the entire abdomen wit h standard open surgical techniques used to treat skin excesses and allow a bdominal muscle plication where necessary offers the advantage of reduced s urgery when compared with full abdominoplasty, while consistently achieving significant contour improvement. This concept is applicable to the majorit y of patients presenting for the treatment of abdominal deformities and has markedly expanded the application of the mini-abdominoplasty concept.