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Composite Body Contouring

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Abstract

Background

Aesthetic surgery of the thoracoabdominal region is one of the most frequently performed surgical procedures in plastic surgery.The combination of circumferential liposuction, autologous fat grafting of the buttocks and/or lower limbs, and the modified transverse abdominoplasty as an adjuvant procedure all done in a single surgical procedure is not very common. The authors present a prospective study of the surgical technique of composite body contouring, emphasizing the low rate of complications and the high overall patient satisfaction.

Methods

A total of 64 consecutive female patients were operated on between January 2004 and January 2007. All the patients who were included in the study were candidates for a classical abdominoplasty. Posterior and lateral syringe-assisted liposuction combined with fat insertion into the buttocks and/or lower limbs was performed. Autologous fat grafting was done in the gluteal area for buttocks enhancement and in the lower limbs to correct contour deformities. Anterolateral liposuction with modified transverse abdominoplasty was done as an adjuvant procedure. Overall satisfaction with body appearance after composite body contouring was rated on a scale of 1–5.

Results

From 1,500 to 4,600 ml of fat was obtained with liposuction (mean = 2,478 ml). Forty-five patients had fat grafting only to the buttocks area. Six patients had fat insertion into the lower limbs and 13 had fat injection into the buttocks and lower limbs. The amount of fat transplanted to the buttocks varied from 165 to 625 ml (mean = 346 ml) and to the lower limbs it varied from 75 to 270 ml (mean = 195 ml). Three patients (5%) suffered from early complications, including infection (3%) and hematoma formation (2%). Nine patients (14%) had late complications, including hypertophic scars (7.5%), dog ears (4.5%), and localized fat excess (2%). Nine patients (14%) underwent revision surgery. Sixty-three percent reported that their appearance after composite body contouring was “very good” (42%) or “excellent” (21%) and 27% responded that their appearance was “good.” Only 10% thought their appearance was less than good, (7% “fair” and 3% “poor”).The average follow-up time has been 3.2 years (range = 2–5 years).

Conclusion

Composite body contouring combines circumferential liposuction, fat grafting of the buttocks and lower limbs, and modified transverse abdominoplasty to accomplish very good aesthetic results in a single surgical procedure with a low rate of complications and high patient satisfaction.

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References

  1. Cormenzana PS, Samprón NM, Escudero-Nafs FJ (2008) Secondary abdominoplasty. Aesthetic Plast Surg 32(3):503–508

    Article  PubMed  CAS  Google Scholar 

  2. Mayr M, Holm C, Höfter E, Becker A, Pfeiffer U, Mühlbauer W (2004) Effects of aesthetic abdominoplasty on abdominal wall perfusion: a quantitative evaluation. Plast Reconstr Surg 114(6):1586–1594

    Article  PubMed  Google Scholar 

  3. Momeni A, Heier M, Bannasch H, Stark GB (2008) Complications in abdominoplasty: a risk factor analysis. J Plast Reconstr Aesthet Surg [Epub ahead of the print]

  4. Gliksman J, Himy S, Ringenbach P, Andreoletti JB (2006) [Abdominoplasty: towards a two procedure surgery? Retrospective study of postoperative complications about 100 cases]. Ann Chir Plast Esthet 51(2):151–156

    Article  PubMed  CAS  Google Scholar 

  5. Illouz YG (1992) A new safe and aesthetic approach to suction abdominoplasty. Aesthetic Plast Surg 16(3):237–245

    Article  PubMed  CAS  Google Scholar 

  6. Matarasso A, Swift RW, Rankin M (2006) Abdominoplasty and abdominal contour surgery: a national plastic surgery survey. Plast Reconstr Surg 117(6):1797–1808

    Article  PubMed  CAS  Google Scholar 

  7. Kolker AR (2008) Improving esthetics and safety in abdominoplasty with broad lateral subcostal perforator preservation and contouring with liposuction. Ann Plast Surg 60(5):491–497

    Article  PubMed  CAS  Google Scholar 

  8. Matarasso A (1991) Abdominoplasty: a system of classification and treatment for combined abdominoplasty and suction-assisted lipectomy. Aesthetic Plast Surg 15:111

    Article  PubMed  CAS  Google Scholar 

  9. Saldanha OR, De Souza Pinto EB, Mattos WN Jr, Pazetti CE, Lopes Bello EM, Rojas Y, dos Santos MR, de Carvalho AC, Filho OR (2003) Lipoabdominoplasty with selective and safe undermining. Aesthetic Plast Surg 27(4):322–327

    Article  PubMed  Google Scholar 

  10. Avelar JM (2006) Abdominoplasty combined with lipoplasty without panniculus undermining: abdominolipoplasty—a safe technique. Clin Plast Surg 33(1):79–90, vii

    Article  PubMed  Google Scholar 

  11. Graf R, de Araujo LR, Rippel R, Neto LG, Pace DT, Cruz GA (2006) Lipoabdominoplasty: liposuction with reduced undermining and traditional abdominal skin flap resection. Aesthetic Plast Surg 30(1):1–8

    Article  PubMed  Google Scholar 

  12. Pereira LH, Sterodimas A (2008) Free fat transplantation for the aesthetic correction of mild pectus excavatum. Aesthetic Plast Surg 32(2):393–396

    Article  PubMed  CAS  Google Scholar 

  13. Pereira LH, Sterodimas A (2008) Aesthetic restoration of axillary contour deformity after lymph node dissection. J Plast Reconstr Aesthet Surg 61(2):231–232

    Article  Google Scholar 

  14. Baroudi R, Moraes M (1991) Philosophy, technical principles, selection, and indication in body contouring surgery. Aesthetic Plast Surg 15(1):1–18 (review)

    Article  PubMed  CAS  Google Scholar 

  15. Ullmann Y, Shoshani O, Fodor A, Ramon Y, Carmi N, Eldor L, Gilhar A (2005) Searching for the favorable donor site for fat injection: in vivo study using the nude mice model. Dermatol Surg 31(10):1304–1307

    Article  PubMed  CAS  Google Scholar 

  16. Rohrich RJ, Sorokin ES, Brown SA (2004) In search of improved fat transfer viability: a quantitative analysis of the role of centrifugation and harvest site. Plast Reconstr Surg 113(1):391–395 (discussion 396–397)

    Article  PubMed  Google Scholar 

  17. Guerrerosantos J (1996) Autologous fat grafting for body contouring. Clin Plast Surg 23(4):619–631

    PubMed  CAS  Google Scholar 

  18. Lewis CM (1991) Transplantation of autologous fat. Plast Reconstr Surg 88(6):1110–1111

    Article  PubMed  CAS  Google Scholar 

  19. Pereira LH, Radwanski HN (1996) Fat grafting of the buttocks and lower limbs. Aesthetic Plast Surg 20(5):409–416

    Article  PubMed  CAS  Google Scholar 

  20. Lewis CM (1992) Correction of deep gluteal depression by autologous fat grafting. Aesthetic Plast Surg 16(3):247–250

    Article  PubMed  CAS  Google Scholar 

  21. Wolf GA, Gallego S, Patrón AS, Ramírez F, de Delgado JA, Echeverri A, García MM (2006) Magnetic resonance imaging assessment of gluteal fat grafts. Aesthetic Plast Surg 30(4):460–468

    Article  PubMed  Google Scholar 

  22. Coleman SR (1995) Long-term survival of fat transplants: controlled demonstrations. Aesthetic Plast Surg 19(5):421–425

    Article  PubMed  CAS  Google Scholar 

  23. Matarasso A (1995) Abdominolipoplasty: a system of classification and treatment for combined abdominoplasty and suction-assisted lipectomy. Plast Reconstr Surg 95:829–836

    PubMed  CAS  Google Scholar 

  24. Pollock H, Pollock T (2000) Progressive tension sutures: a technique to reduce local complications in abdominoplasty. Plast Reconstr Surg 105(7):2583–2586 (discussion 2587–2588)

    Article  PubMed  CAS  Google Scholar 

  25. Khan UD (2008) Risk of seroma with simultaneous liposuction and abdominoplasty and the role of progressive tension sutures. Aesthetic Plast Surg 32(1):93–99 (discussion 100)

    Article  PubMed  Google Scholar 

  26. Baroudi R, Ferreira CA (1996) Contouring the hip and the abdomen. Clin Plast Surg 23(4):551–572 (discussion 572–573)

    PubMed  CAS  Google Scholar 

  27. Rieger UM, Erba P, Wettstein R, Schumacher R, Schwenzer-Zimmerer K, Haug M, Pierer G, Kalbermatten DF (2008) Does abdominoplasty with liposuction of the love handles yield a shorter scar? An analysis with abdominal 3D laser scanning. Ann Plast Surg 61(4):359–363

    Article  PubMed  CAS  Google Scholar 

  28. Stewart KJ, Stewart DA, Coghlan B, Harrison DH, Jones BM, Waterhouse N (2006) Complications of 278 consecutive abdominoplasties. J Plast Reconstr Aesthet Surg 59(11):1152–1155

    Article  PubMed  CAS  Google Scholar 

  29. Pereira LH, Sterodimas A (2008) Correction for the iatrogenic form of banana fold and sensuous triangle deformity. Aesthetic Plast Surg 32(6):923–927

    Article  PubMed  Google Scholar 

  30. Pereira LH, Sterodimas A (2008) Treatment of iatrogenic abdominal contour irregularities. Aesthetic Plast Surg [Epub ahead of print]

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Correspondence to Luiz Haroldo Pereira.

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Pereira, L.H., Sterodimas, A. Composite Body Contouring. Aesth Plast Surg 33, 616–624 (2009). https://doi.org/10.1007/s00266-009-9348-6

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  • DOI: https://doi.org/10.1007/s00266-009-9348-6

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