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The 100 % increase in the demand for abdominal surgery quality fenofibrate 160mg ideal cholesterol panel, unlike with other procedures purchase fenofibrate mastercard high cholesterol medication uk, shows patient acceptance of the technique and how patients have recognized the improve- large areas of the flap where the perforating vessels are sec- ment it has brought. The decrease in the need for surgical tioned, taking into consideration that they represent 80 % of the revisions is another fact that motivates more surgeons to per- blood supply of the abdominal wall according to the literature form this technique. Lipoabdominoplasty is based on the selective tant for draining the liquid injected during liposuction. It also proves to be particularly indicated necessary, starting with cases in which there is a large amount for smokers because of the preservation of the perforating of skin flaccidity and sufficient adipose accumulation to permit abdominal vessels. Traditional abdominal plastic surgery is associated with a This technique is not simply using liposuction while per- high rate of morbidity, because of the necessity for undermining forming abdominoplasty but represents a much wider 384 O. Lipoabdominoplasty is based on the selective undermining of the abdominal flap in the superior medial line, resulting in the preservation of arteries, veins, lymphatic vessels, and nerves. Classic undermining has been replaced with cannula undermining; as a result, the blood supply from the abdomi- nal perforating vessels is preserved. All of these rates can be observed in a comparison of traditional abdominoplasty with lipoabdominoplasty both performed by the authors. In the same way, the percentage of surgical revisions decreased from 20 to 10 % when only lipoabdominoplasty was performed, remaining so for 9 years. The cases of surgi- cal revision resulting from complementary liposuction and postoperative skin flaccidity (1. Status of the patient preoperatively (a – c) and postop- sented a great amount of flaccidity. There was a need for eratively (d – f) Table 1 Personal statistics of abdominal surgeries 1979–1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009a Total Abdominoplasty 469 25 – – – – – – 1 – – 495 Lipoabdominoplasty – 15 45 55 64 62 65 68 71 75 68 588 aSurgeries until September 2009 Table 2 Surgical revision in lipoabdominoplasty 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 Primary total = 588 15 45 55 64 62 65 68 71 75 68 Scars 3 5 4 3 4 3 3 4 2 1 Skin flaccidity – – 1 2 1 1 1 2 – 1 Insufficient liposuction – – 1 2 2 1 1 1 1 – Excessive liposuction – – – – – – – – – – Infection – – – – – – – – – – Other causes – – – – 1 – – – – – Total 3 5 6 7 8 5 5 7 3 2 Percentage 20 % 11 % 11 % 11 % 13 % 8 % 7 % 10 % 4 % 3 % Lipoabdominoplasty: Saldanha’s Technique 385 Fig. Voloir P (1960) Operation plastiques sus-aponevrotiques sur la • A better body contour is achieved because liposuc- paroi abdominale anterieure. Johns Hopkins • There is less morbidity because of the preservation Med J 10:197 3. Vernon S (1957) Umbilical transplantation upward and abdominal of perforating vessels and the absence of dead space. Ann • There is faster postoperative recovery and a shorter CongBras Plast Surg 1:9 8. Matarasso A (1995) Liposuction as an adjunct to full abdomino- who have previously undergone bariatric surgery or plasty. Lockwood T (1995) High-lateral-tension abdominoplasty with super- ficial fascial system suspension.

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