Thank you for your questions and comments, which I will address individually. First, my colleagues and I do not have the exact incidence of secondary abdominoplasty in massive weight loss patients. However, we have noted that there is significant damage in the remaining unresected skin in this population of patients (nonexcised portions). Consequently, some further relaxation is expected. Indeed, anecdotally it seems that a proportion of postoperative massive weight loss abdominoplasty patients will feel at some point that they could be “tighter,” as their skin undergoes postoperative relaxation. Second, in my experience, whether secondary abdominoplasty patients had an intervening pregnancy or not, the midline rectus muscle will benefit from additional reinforcement.
Third, any full second operation (e.g., liposuction followed by an abdominoplasty) or an additional liposuction operation was considered secondary. Revisions (e.g., dog-ears) or touch-ups (e.g., spot areas of liposuction) were not considered secondary “complete” operations. A private duty nurse accompanies the patient to a hotel-type facility (the patient ambulates). They are versed in our postoperative care and expectations. Parenthetically, please note that Figure 1 of the article should read full abdominoplasty n = 1, not 4.5.
The author has no financial interest to declare in relation to the content of this communication.
Alan Matarasso, M.D.
1009 Park Avenue
New York, N.Y. 10028
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