Preservation of the supportive tissue layer on the superficial surface of Scarpa’s fascia (that may contain lymphatics) is probably beneficial for seroma prevention. The recent finding that the lymphatic drainage from the lower abdomen courses superficial to Scarpa’s and pierces the fascia low, 2–3 cm proximal to the inguinal ligament supports this assumption.37
Seromas have been effectively treated by the corresponding author with local and systemic steroids before 2009, and Janis et al.38 have recently confirmed the inflammatory nature of seroma fluid.19 Treatment with steroids may be feasible for long-standing seromas; however, when steroids are used for prevention or treatment of fresh seromas, the benefits have to be weighed against the potential effect of steroids on the tensile strength of the healing tissues.
The LAA technique is based on sound surgical principals. The LAA flap’s extended downward reach is enabled by its rich blood supply. The LAA technique is uncomplicated to perform. The basic surgical maneuvers of hydro and lipo-dissection and separation of the subcutaneous tissue from the muscular fascia are straightforward and the rest follows from there. Backed by a 22-year experience gained by the authors and others, the LAA technique is suggested to surgeons as a proven alternative to other lipoabdominoplasty techniques.
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