Mastering the Lipoabdominoplasty: Superior Pull-Down, Miniabdominoplasty, and TULUA Techniques

Carlos Oscar Uebel, Pedro Salomão Piccinini

Research output: Chapter in Book/Report/Conference proceedingChapter

Abstract

Abdominoplasty and liposuction can be safely combined to correct most abdominal deformities. We propose three approaches to expand indications, increasing patient safety and results. First, the “superior pull-down” technique is used to overcome concerns about the ability of the flap to reach the suprapubic incision, allowing a tension-free closure. We do this routinely, with the superior abdominal incision performed prior to the suprapubic incision. Second, we indicate miniabdominoplasty for patients with desires for a shorter scar and preservation of the native umbilicus. It is helpful for patients with isolated lower abdominal laxity and a long distance from the suprapubic incision to the umbilicus. However, a minority of patients are good candidates. Third, we adopted TULUA, a modified technique first described by Villegas, expanding the number of candidates for abdominoplasty; this lipoabdominoplasty involves transverse plication, no flap undermining, extensive flap liposuction, neoumbilicoplasty, and a low transverse suprapubic incision, being especially useful in patients with prior abdominal surgery, obesity, umbilical hernias, massive weight loss or active smoking. Mastering the three techniques allows the plastic surgeon to widen the indications of abdominoplasty while maintaining the safety profile. Correct preoperative counseling, patient selection, and physical examination to determine the correct technique for the appropriate individual are the keys to excellent and safe postoperative results.

Original languageEnglish (US)
Title of host publicationTULUA Abdominoplasty
Subtitle of host publicationTransverse Plication Technique
PublisherElsevier
Pages549-561
Number of pages13
ISBN (Electronic)9780443118821
ISBN (Print)9780443119828
DOIs
StatePublished - Jan 1 2024
Externally publishedYes

Keywords

  • Abdominoplasty
  • Hernia
  • Lipectomy
  • Lipoabdominoplasty
  • Patient safety
  • Patient selection
  • Umbilical
  • Umbilicus
  • Weight Loss

ASJC Scopus subject areas

  • General Medicine

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