Inverse Mini-abdominoplasty

Abstract

The patients who present with limited deformities confined to the central lower abdomen can be treated effectively with a mini-abdominoplasty with a full-length abdominal wall plication. This procedure usually encompasses a shortened scar and a smaller skin excision and is ideal for younger patients with lower abdominal soft-tissue laxity that is not significant enough to allow us to perform a full abdominoplasty. If the mentioned skin problems affect majorly the infra-umbilical area, if the skin quality is generally good but the existing wall laxity is considerable or if the downward traction asserted to the abdominal skin demonstrates an absence of sufficient laxity to bridge the gap of a full abdominoplasty, a mini abdominoplasty is again indicated. However, it should be noted that performing a mini-abdominoplasty without full abdominal plication is a sure way to patient dissatisfaction. This is also valid for an incomplete plication covering only the lower part of the abdomen. In such a case, the tightening of the lower abdomen might even result in bulging of the upper part. Finally, the presence of substantial visceral fat accumulation prevents any successful result even if extensive muscular tightening would be performed.

Abdominoplasty candidates can visit plastic surgeons with a wide variety of problems. While some have serious skin excess and abdominal wall laxity after heavy weight loss, many have less drastic complaints of weight and skin quality related to changes from aging, pregnancy, and childbirth. Therefore, each patient needs to be carefully assessed, and based on the characteristics of each individual, the proper type of contouring procedure shall be chosen [1]. The assessment must evaluate the component irregularities of the abdominal wall, which consist of varying degrees of adiposity, loose or redundant skin, and laxity of the musculofascial units [2].