Abdominoplasty Revision Using Tissue Expansion
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CASE REPORT
AESTHETIC
Abdominoplasty Revision Using Tissue Expansion Omar Marwan Kadri M. Mark Mofid
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Setara Moosa
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Received: 4 November 2012 / Accepted: 25 February 2013 / Published online: 22 March 2013 Ó Springer Science+Business Media New York and International Society of Aesthetic Plastic Surgery 2013
Abstract Postoperative revision after abdominoplasty may be necessary at times to improve contour, remove asymmetries, revise the umbilicus, or improve the scar. This report describes the case of an abdominoplasty performed outside the United States that resulted in an inappropriately high and unattractive scar with an elevated pubic hairline. The patient presented to our clinic 2 years after her initial surgery, and a scar-lowering procedure was performed with the assistance of tissue expansion. The reconstructive effort was staged over a period of 4 months, with an initial procedure to repair several hernias, bury the umbilicus, and place a tissue expander. Over several months, 3.5 L of expansion was performed. During a subsequent surgery, the tissue expander was removed, and the scar was successfully lowered and improved. The healing was uneventful, and the patient was satisfied with the outcome. The final result is exhibited in 1-month follow-up photographs. Level of Evidence V 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.
O. M. Kadri David Geffen School of Medicine at UCLA, Los Angeles, CA, USA S. Moosa San Diego Skin, Inc., 4150 Regents Park Row, Suite #300, La Jolla, CA 92037, USA
Keywords Abdominoplasty revision Scar-lowering procedure Tissue expansion Abdominoplasty is the fourth most common aesthetic surgical procedure performed by American Society of Plastic Surgeons (ASPS) member surgeons, with nearly 116,000 procedures performed in 2010 [1]. Although the vast majority of these surgical procedures are performed without any complications, patients may at times present with high or excessively widened surgical scars from incisions placed too high on the abdomen or from excessive removal of lower abdominal tissue. In these cases, a simple scar revision is an inadequate measure for lowering of the abdominoplasty scar due to an inherent deficit in the amount of tissue remaining for resurfacing of the abdomen. The use of tissue expanders for abdominal wall reconstruction is an accepted and previously published technique for cases with large hernias and loss of abdominal domain [2, 3]. These applications have included treatment for herniation, correction of burn-related scars, and abdominal wall defects from omphalocele or trauma [3–6]. To our knowledge, the use of tissue expanders to lower the abdominal scar has not been described previously. This case report describes a technique for lowering the abdominal scar through a staged intervention involving placement of the tissue expander in the central u
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