High-Definition Excisional Body Contouring: Mini Lipoabdominoplasty (FIT Mommy) and Enhanced Viability Abdominoplasty

The Role of Helium Plasma-Assisted Liposuction in Lipoabdominoplasty After Weight loss

BACKGROUND

Weight loss patients present with major deformities, leading to the rapid development of new body contouring techniques to address their specificities. Abdominal skin laxity is often major due to rapid weight loss and inflammation secondary to bariatric surgeries and is often present in both vertical and horizontal axes. Through this article, the authors wish to demonstrate the use of helium plasma radiofrequency technology for supraumbilical skin tightening following lipoabdominoplasty.

METHODS

A retrospective single-center cohort study was performed, including 100 consecutive patients undergoing HPRF-assisted lipoabdominoplasty. Patient characteristics, intra- and postoperative outcomes and complications were collected. A postoperative Likert scale evaluated patient satisfaction at 6-month follow-up.

RESULTS

The mean age was 37, and the median preoperative BMI was 25.3. The median follow-up period was 19.7 months. Among the 100 included patients, no major complication occurred. Minor complications included wound dehiscence (1%), subcutaneous emphysema (2%), hyperpigmentation (8%), seroma (6%), and hematoma (2%). Overall satisfaction was high with 88% of 5/5 evaluations on the Likert scale.

CONCLUSION

HPRF-assisted lipoabdominoplasty stands as a safe and efficient refinement in post-bariatric patients and can be used to avoid vertical scars and decrease scar tension. This technology seems, therefore, valuable to enhance body contouring procedures while minimizing morbidity.

LEVEL OF EVIDENCE IV

This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine Ratings, please refer to Table of Contents or online Instructions to Authors www.springer.com/00266 .

Ultrasound and Helium Plasma-Assisted Liposuction for Body Contouring: A Single-Retrospective Cohort Study of 639 Patients

BACKGROUND

Over the past two decades, liposuction techniques have significantly evolved, moving from basic fat removal to sophisticated methods aimed at improving safety, efficiency, and cosmetic outcomes. This study evaluates the efficacy and safety of a combined approach using ultrasound-assisted liposuction (UAL) and helium plasma radiofrequency (HPRF) technology to enhance skin tightening without the need for extensive surgical interventions.

METHODS

We conducted a retrospective analysis of 639 patients who underwent the combined UAL and HPRF liposuction technique. The patient cohort had an average age of 31.5 years and a mean BMI of 27.9 kg/m2. The procedure predominantly targeted the abdomen, with an average of 2.4 body areas treated per patient. Surgical duration averaged 118 minutes, with a mean aspirate volume of 1698 mL.

RESULTS

Minimal residual skin laxity was observed in 87% of patients, and 91% achieved excellent improvement in body contouring. The complication rates were low, with minor occurrences of seroma (5.6%) and a very low incidence of infection (0.3%). This combined technique demonstrated safety and efficacy, providing significant skin tightening and reducing recovery time compared to more invasive procedures.

CONCLUSIONS

The combined use of UAL and HPRF technology offers a safe and effective method for enhancing skin tightening and improving body contouring outcomes. Despite the promising results, this study acknowledges the limitations of its retrospective design. Future prospective, multicenter studies are recommended to further validate these findings. This technique represents a significant advancement in the field of cosmetic surgery, emphasizing minimally invasive solutions with substantial esthetic benefits.

LEVEL OF EVIDENCE IV

This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Surgical Correction of Low-positioned Umbilicus after Mini-abdominoplasty

Background

The umbilicus detachment and reinsertion in umbilical float mini-abdominoplasty results in its lower position with or without shape distortion. This event creates a stigmatizing look, elongating the upper abdomen and creating variable grades of infra umbilical/pubis bulging. This lack of proportion causes an unpleasant, artificial look, and is very difficult to fix. The study aimed to describe a sequence of abdominoplasty and combined upper abdomen horizontal muscle plications to correct umbilicus malposition after a mini-abdominoplasty.

Methods

Over a period of 24 months, 12 patients underwent a liposuction (suction-assisted liposuction) and abdominoplasty with horizontal supraumbilical muscle plication. All patients underwent objective measurements before and after the procedure, using digital image measurements by Mirror Image software, version 6.0 (Fairfield, N.J.). The follow-up evaluation was performed 12 months postoperatively. Statistical analysis was performed using IBM SPSS Statistics V26.

Results

Over 24 months, 12 patients (100%), who underwent abdominoplasty combined with horizontal plication in the upper abdominal wall, have shown adequate umbilicus elevation (2.98 ± 0.242 cm; 95% confidence level), restoring the abdominal muscle wall proportion at 12 months follow-up. One patient (8%) had a seroma, and one (8%) had a small muscular hernia (1.5 cm) in the lower abdomen.

Conclusions

The combination of abdominoplasty and upper horizontal muscle plication can fix the malpositioned umbilicus, restoring the aesthetic and anatomic proportions in those patients who underwent an umbilical float mini-abdominoplasty.

Ultrasonic- and Ultrasound-assisted Improvement of Silhouette of the Torso: Bone Structure High-definition Remodeling (Part I)

Background

High-definition liposculpture allowed plastic surgeons to achieve better aesthetic results by carving the underlying muscles and contours in a new way. Several authors have improved the original technique by adding other procedures and new technologies. We designed a new improvement by incorporating bone transformation surgery to overcome the lack of silhouette at the waist and, as a result, optimize the breast-waist-hip ratios.

Methods

We carried out a prospective multicenter study, with five different surgeons performing the same rib remodeling technique for waist definition. We used an ultrasonic piece for costal corticotomy and real-time ultrasound imaging to perform green-stick fractures over the last two or three floating ribs. Ours is a new technique based on the prior one described by Kudzaev.

Results

We reported 131 consecutive patients who were enrolled in this study. Waistline diameter decreased an average of 8 cm after surgery (P < 0.05). Most patients were women (n = 125, 95.4%). No major complications were reported. Most common complication was prolonged pain, with only three cases of contour asymmetry, all of which were attributable to noncompliance of constantly wearing the corset + compressive garments. Patients reported a high satisfaction rate and fast recovery (Body-QoL survey).

Conclusions

Ultrasonic- and ultrasound- assisted indentation surgery of the thorax is a safe and reliable technique for waistline definition, with a high satisfaction rate, almost-invisible scars, and minimal risk for complications. Incorporation of high-definition liposculpture to rib remodeling opens up a new horizon for bone structure modification surgery (S-high-definition remodeling) that can be safely performed for patients who seek better aesthetic outcomes in body contouring.

Rectus Muscle Plication in Mini-abdominoplasty with Umbilicus Preservation

Diastasis recti is a frequent problem that women, particularly, experience after pregnancy. It is an abdominal wall defect in which there is more than 2 cm separation between the abdominal rectus muscles. Aside from being repaired most commonly with a full abdominoplasty, in some cases, diastasis might present with minimal excessive adipocutaneous tissue, thus requiring a mini-abdominoplasty. Because umbilical transposition is not needed in that latter scenario, diastasis repair is only possible by ligating and cutting the existing umbilical stalk to be able to have a direct clear access to the supraumbilical linea alba. However, detaching the umbilical stalk will most certainly lead to the displacement of the umbilicus inferiorly. To overcome this problem, we performed a modified mini-abdominoplasty technique, which repairs the recti diastasis, keeps the umbilical stalk in place, and leaves behind a mini-abdominoplasty scar, thus providing a more cosmetically appealing result in addition to a radical solution to the defect. Moreover, this technique can be performed by any qualified plastic surgeon under basic operating settings.

Safety and Efficacy of Third-Generation Ultrasound-Assisted Liposuction: A Series of 261 Cases

BACKGROUND

The introduction of third-generation ultrasound-assisted liposuction (3rd UAL) allows for a less invasive modality of both deep and superficial lipectomy while offering improved skin retraction and reduced rate of complications. This study examined the efficacy and safety profile of this technology over 15 years of clinical experience.

METHODS

A consecutive series of patients treated from 2005-2020 by the senior author were reviewed for demographic and anthropometric measurements, intraoperative settings, surgical outcomes, and complications via retrospective chart review. Body-Q survey was used to assess patient satisfaction.

RESULTS

A total of 261 patients underwent 3rd UAL in 783 areas. There were 238 female and 23 male patients with an average age of 43.5 years and BMI of 27.4 kg/m². The most frequently treated areas were the trunk and lower limbs. An average of 2840 mL of wetting solution was used with an average of 2284 mL of lipocrit aspirate. About 65% of the cases were done in conjunction with another procedure. Overall complication rate was 4.6%, contour irregularity (1.9%), seroma (0.8%), cellulitis (0.8%), pigmentation changes (0.4%), and electrolyte imbalance (0.4%), with a minimum follow-up of 6 months. 78% of patient would undergo the procedure again and 86% would recommend it.

CONCLUSION

Third-generation ultrasound-assisted liposuction can be used effectively and safely, either alone, or in conjunction with other plastic surgery procedures. VASER liposuction allows surgeons to address superficial fat plane and enhanced skin tightening. Rate of complications are lower than that of traditional liposuction with equivalent or higher patient satisfaction.

LEVEL OF EVIDENCE IV

This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .