Since she had so much skin to remove, he recommended an advanced type of tummy tuck called a fleur-de-lis abdominoplasty, also known as a FDL tummy tuck. These findings must be balanced against a potentially longer operation. During her consultation, the doctor pointed out that an abdominoplasty or tummy tuck was the best method to rid her of excess fat and skin while still tightening the lax muscles underneath. Methods: A review of massive weight loss patients enrolled in an institutional review board-approved prospective registry was performed on consecutive patients undergoing abdominoplasty by a single surgeon. Fleur-de-lis potentially creates a better symptom correction and cosmetic outcome by resecting maximal skin in both vertical and horizontal directions. The authors analyzed the impact of vertical (fleur-de-lis) excision on complications when compared with traditional transverse excision. Our experience with primarily fleur-de-lis panniculectomies shows a complication rate lower than most published data. There is limited undermining of tissue which minimizes/eliminates skin necrosis. There are many benefits of fleur-de-lis over traditional panniculectomy, even for medical necessity cases. Patients with BMI <30 had 10 complications compared with patients with BMI ≥30 had 15 complications. Six males (40%) had more complications compared with 18 females (15.7%) (P = 0.034). Twenty-two patients (17%) had complications, with 5 in the traditional group (17%) and 17 in the fleur-de-lis group (17%) (P = 1.0). Fifty-seven patients had additional procedures performed at the time of panniculectomy. Mean weight loss from bariatric surgery to panniculectomy was 58.2 kg, with an average body mass index (BMI) of 30. This is a retrospective chart review of 130 consecutive postbariatric surgery patients who had panniculectomy over a 2-year period at our institution.Ī total of 30 patients underwent a traditional panniculectomy and 100 patients had a fleur-de-lis panniculectomy. In these patients, many surgeons avoid the fleur-de-lis panniculectomy, despite the body contour aesthetic advantage, because of increased time, more scarring, and a perceived increase in complications. It may be also fraught with complications due to large incisions and potential for dead-space. Panniculectomy for symptomatic relief of rashes is commonly performed, but an isolated infraumbilical amputation-type panniculectomy is a highly unaesthetic procedure, leaving many patients deeply dissatisfied. Your panniculectomy will result in a flatter, improved abdominal contour.Plastic surgeons are faced with increasing numbers of patients presenting for insurance-covered skin excision procedures following bariatric surgery. Sutures, skin adhesives, tapes or clips close the skin incisions. The belly button stem is then repositioned and carefully drawn through the new abdominal opening, then sutured into its revised position? Step 3 – Closing the incisions The excess skin is trimmed and the remaining skin is sutured together. The remaining upper abdominal skin is pulled down like a window shade. An incision is also typically made around the navel, although in certain cases the navel may have to be sacrificed. In some instances, a vertical midline incision is necessary in individuals who have excess skin and tissue in the transverse dimension. The shape and length of the incision will be determined by the amount of excess skin. Step 2 – The incisionĪ panniculectomy requires a horizontally-oriented incision in the area between the pubic hairline and belly button. Your doctor will recommend the best choice for you. The choices include intravenous sedation and general anesthesia. Medications are administered for your comfort during the surgical procedure. The panniculectomy procedure includes the following steps: Step 1 – Anesthesia What are the steps of a panniculectomy procedure?
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