الفهرس 
Abdominal wall anatomy and vascular supplyOnly 14 pages are availabe for public view
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Abstract
Lipoabdominoplasty present an evolution of technique in body contouring and a successful approach to safely combine excisional body contouring with a way to reduce fat deposits found within regional aesthetic units. Classical abdominal plastic surgery results in a high rate of morbidity, due to the necessity for a large undermining of the flap where the perforating vessels are sectioned. In all female patients’ cases, possible future pregnancy discussed with the patients and, if this is anticipated, it is suggested that abdominoplasty be performed following the last pregnancy. Blood supply of anterior abdominal wall is expressed in 3 zones: Zone I consists of the midabdomen and is mainly supplied by the deep epigastric arcade. Zone II consists of branches from the external iliac artery providing supply for the lower abdomen, and Zone III, which consists of the flanks and lateral abdomen, is supplied by the intercostal, subcostal, and lumbar arteries. A selective undermining along the internal borders of the rectus abdominal muscles, corresponding to 30% of traditional undermining, thus preserving the abdominal perforating vessels, safely performing liposuction and abdominolipoplasty at the same time. Undermining is performed in the median line of the upper abdomen, between the internal edges of the abdominal rectus muscles.The two fundamentals of this technique are preservation of abdominal wall perforating vessels and the use of superficial liposuction, A narrow central tunnel between the vascular perforators can then be safely opened in order to accomplish rectus placation, This technique makes it possible to preserve at least 80% of blood supply to the abdominal wall, to preserve sensory nerves and lymphatic vessels, and to have fewer complications than with traditional abdominoplasty. The preservation of the Scarpa’s fascia is very important for many reasons. It causes less bleeding due to the preservation of the inferior perforating vessels; it is a homogeneous support for the upper flap, which becomes thinner in its descent; it causes the contention of scars laterally and offers a better adherence between the flap and the deep layers. Lipoabdominoplasty allowed plastic surgeon to operate patient that were considered before as relative contraindication with reduced risk of complications. Ultrasound abdomen is mandatory before lipoabdominoplasty to rule out hernia , ascitis on splenomegally, a hepatomegally or any large intrabdominal mass. Lipoabdominoplasty is contraindicated for Patients who are medically at high risk like those with: • Uncorrected coagulopathies, significant cardio-pulmonary. • Compromise and viscerally obese patients, globally obese. • Functionally compromised patients. • Patients with unrealistic expectations are to be excluded. Smokers who cannot give up the habit need to be counselled carefully regarding risks and potential complications which tend to be higher in them. Weight loss patients whether by sport& diet& medications or by surgery should be prepared very well, coagulation profile should be done preoperative and cross matching should be done for them preoperative, intraoperative and postoperative. Pressure garment must be applied immediately post operative and kept for at least 3 weeks. 2 drains should be inserted and not to be removed unless wound discharge is less than 30cc serosanginous fluid within 24 hour.