الفهرس 
Anatomy of The Abdominal WallOnly 14 pages are availabe for public view
 |  | from | 32 |  |  |
| | | from | 32 | | |
Abstract
Abdominoplasty is one of the most common plastic surgical procedures performed, addressing skin and abdominal wall laxity and smoothing contour. This is the procedure that rejuvenates the abdomen after childbearing, abdominal surgery, and significant weight loss.
The procedure has been revised and updated countless times, whereas the principal belief of reduction of the redundant panniculus and correction of rectus fascia diastasis has remained.
When performing abdominal contouring procedures, it is necessary to understand the anatomy of the abdominal region and how it relates to the specific surgical operation being performed. The vascularity of the abdominal soft tissue is particularly important. Understanding the muscular and fascial components of the abdominal wall is important for myofascial plication. The sensory distribution is also important when considering incision placement for abdominal body contouring procedures. Specific caveats of the abdominal anatomy are important to note, as they play an important role in simplifying and safely achieving excellent aesthetic results in abdominal contouring procedures.
Numerous articles have been published about the different techniques of the abdominoplasty procedure and date back from over a century ago.
Many surgical techniques are currently available for abdominal contouring. Based on the individual characteristic of the patient’s anatomy and their goals, these abdominal contouring procedures include liposuction alone and different techniques of abdominoplasty procedures with or without liposuction.
The mini abdominoplasty procedure is highly variable, depending on the clinical findings and patient desire. Such procedures usually encompass a shortened scar, a smaller skin excision, and no umbilical transposition as in a full abdominoplasty. Mini abdominoplasty is ideal for younger patients with lower abdominal soft-tissue laxity that is not significant enough to allow a full abdominoplasty skin resection. Thorough abdominal liposuction is usually an important component of this procedure, as well as strong myofascial plication.
The full abdominoplasty procedure is suitable for the majority of patients seeking abdominal contouring. This procedure addresses and corrects excess abdominal adiposity and soft-tissue laxity, rectus diastasis and abdominal wall laxity, and skin striae.
Circumferential abdominoplasty is an ideal procedure for patients who have experienced massive weight loss and who have circumferential tissue laxity of the trunk. It allows for complete correction of buttock ptosis, lateral and anterior thigh laxity, abdominal tissue redundancy, and
mons ptosis. It also allows for concurrent strong myofascial plication, which further improves abdominal contour.
Fleur De Lys abdominoplasty is one of the new trends in abdominoplasty. It is a safe and effective procedure to correct abdominal contour abnormalities in individuals with excessive soft tissue in both the vertical and transverse orientation.
The advent of minimally invasive surgery has led surgeons to seek a method that would provide cosmetic improvement of the abdominal wall laxity and rectus diastasis and would minimize the resultant scar. Endoscopically assisted techniques of abdominoplasty such as plication of the rectus fascia through an umbilical incision by using an endoscopic retractor were described. These approaches have been labeled “endoscopic abdominoplasties”.
Despite advancements in abdominoplasty techniques, however, a significant complication rate still is associated with abdominoplasty including flap necrosis, seroma, hematoma, infections, and fat necrosis, wound dehiscence, and delayed healing.
The most of new trends in abdominoplasty are about how to deal with complications. Seroma formation is the most common complication associated with abdominoplasty. There are many papers had been published in the last few years to prevent seroma .A number of approaches have been explored to reduce wound drainage and seroma formation in abdominoplasty. These include the placement of closed suction drains, avoidance of electrocautery, the use of progressive tension (PTS) or quilting suture techniques, the use of fibrin sealants, pressure dressings, immobilization of the patient to reduce postsurgical shearing forces between abdominal tissue layers, preservation of Scarpa’s fascia, and recently, a new lysine-derived urethane adhesive (TissuGlu,)
Reducing the incidence of complications is an important focus for all surgical procedures. This is especially the case with cosmetic procedures, where relatively healthy and functionally normal patients undergo elective surgery to improve their appearance. Patient selection, preoperative screening, selection of the appropriate surgical procedure, and good surgical technique are all important in avoiding or reducing the incidence of complications.