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Analysis of Extended Deep Fat Pad Excision in Abdominoplasty

Nunes da Costa, João MD; Matias, Júlio MD

doi: 10.1097/SAP.0000000000000791
Aesthetic Surgery

Background Because abdominoplasty flap’s major vascularization is suprafascial, some surgeons perform excision of the deep fat pad below Scarpa’s fascia to achieve a better abdominal contour and balance the lower abdominal projection above and below the scar. The dimensions of this excised adipose flap and its correlations to both the classic abdominoplasty flap and patient biometrics have not been studied yet and are the aim of this article. Short-term complication outcomes are also reported.

Methods We performed a prospective case series study, operating 74 consecutive women using an otherwise standard abdominoplasty technique, and recorded patient variables, flap dimensions, and complications.

Results Average values are as follows: BMI, 27.35 kg/m2; total flap weight, 1868 g; adipose flap weight, 157 g (corresponding to 9% extra flap weight); adipose flap height, 7.2 cm; and preserved infraumbilical deep fat pad thickness, 7.7 mm. Statistical analysis of correlations between variables was performed.

Conclusions Increased patient weight, umbilical perimeter, BMI, and width of the operative specimen can be used to predict a heavier extra adipose flap. The extra fat excision is safe, preventing inadvertent invasion of the abdominoplasty flap’s suprafascial plane that can happen with liposuction. No flap necroses were observed. The use of this technique may prove useful to achieve a slimmer abdominal contour and harmonize it with the pubic region.

From the *Department of Plastic, Reconstructive and Maxillofacial Surgery, Hospital de Egas Moniz–CHLO, Lisbon, Portugal; and †Hospital St. Louis, Lisbon, Portugal.

Received December 8, 2015, and accepted for publication, after revision February 4, 2016.

Conflicts of interest and sources of funding: The authors certify that they have no affiliations with or involvement in any organization or entity with any financial interest (such as honoraria; educational grants; participation in speakers' bureaus; membership, employment, consultancies, stock ownership, or other equity interest; and expert testimony or patent-licensing arrangements), or nonfinancial interest (such as personal or professional relationships, affiliations, knowledge, or beliefs) in the subject matter or materials discussed in this manuscript.

Reprints: João Nunes da Costa, MD, Hospital de Egas Moniz, Centro Hospitalar de Lisboa Ocidental Lisboa, Lisboa, Portugal. E-mail:

Ethical Standards: The authors declare that this study was performed complying with the principles outlined in the Declaration of Helsinki of Ethical Principles for Medical Research Involving Human Subjects. All persons gave their informed consent before their inclusion in the study.

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