Deep-Plane Lipoabdominoplasty in East Asians

BACKGROUND: The objective of this study was to develop a new surgical technique by combining traditional abdominoplasty with liposuction. This combination of operations permits simpler and more accurate management of various abdominal deformities. In lipoabdominoplasty, the combination of techniques is of paramount concern. Herein, we introduce a new combination of liposuction and abdominoplasty using deep-plane flap sliding to maximize the benefits of both techniques. METHODS: Deep-plane lipoabdominoplasty was performed in 143 patients between January 2007 and May 2014. We applied extensive liposuction on the entire abdomen followed by a sliding flap through the deep plane after repairing the diastasis recti. The abdominal wound closure was completed with repair of Scarpa's fascia. RESULTS: The average amount of liposuction aspirate was 1,400 mL (700-3,100 mL), and the size of the average excised skin ellipse was 21.78×12.81 cm (from 15×10 to 25×15 cm). There were no major complications such as deep-vein thrombosis or pulmonary embolism. We encountered 22 cases of minor complications: one wound infection, one case of skin necrosis, two cases of undercorrection, nine hypertrophic scars, and nine seromas. These complications were solved by conservative management or simple revision. CONCLUSIONS: The use of deep-plane lipoabdominoplasty can correct abdominal deformities more effectively and with fewer complications than traditional abdominoplasty.

Deep-Plane Lipoabdominoplasty in East Asians

BACKGROUND: The objective of this study was to develop a new surgical technique by combining traditional abdominoplasty with liposuction. This combination of operations permits simpler and more accurate management of various abdominal deformities. In lipoabdominoplasty, the combination of techniques is of paramount concern. Herein, we introduce a new combination of liposuction and abdominoplasty using deep-plane flap sliding to maximize the benefits of both techniques. METHODS: Deep-plane lipoabdominoplasty was performed in 143 patients between January 2007 and May 2014. We applied extensive liposuction on the entire abdomen followed by a sliding flap through the deep plane after repairing the diastasis recti. The abdominal wound closure was completed with repair of Scarpa's fascia. RESULTS: The average amount of liposuction aspirate was 1,400 mL (700-3,100 mL), and the size of the average excised skin ellipse was 21.78×12.81 cm (from 15×10 to 25×15 cm). There were no major complications such as deep-vein thrombosis or pulmonary embolism. We encountered 22 cases of minor complications: one wound infection, one case of skin necrosis, two cases of undercorrection, nine hypertrophic scars, and nine seromas. These complications were solved by conservative management or simple revision. CONCLUSIONS: The use of deep-plane lipoabdominoplasty can correct abdominal deformities more effectively and with fewer complications than traditional abdominoplasty.

How to get the Best Results in Transaxillary Breast Augmentation with Anatomic form Stable Implants: Pocket Shapes, Insertion, and Maintenance

Although IMF incision is known the best way for anatomic implant, most Korean doctors and patients hesitate IMF incision. Anatomic form stable implants have some benefits such as less prominent upper pole, less wrinkles and ripples, and less rupture rate than round cohesive type I implants. However more concern is necessory for placing the anatomic implants. The Korean Academic Association of Breast Surgery(KAABS) planned to support some tips for using anatomic form stable implants through axillary incision. The KAABS gathered and analyzed the concepts of Korean plastic surgeons who have experienced transaxillary breast augmentation with anatomic form stable implants. The KAABS requested them of their concepts of 9 basic categories: entrance dissection, pocket dissection, lubricant, inserting aids, skin protector, inserting direction, suction drainage, dressing, compression garment, and their key considerations. Eight expert surgeons suggested their own cutting edge methods of transaxillary breast augmentation with the anatomic form stable implant, however each surgeon should find his or her own method. Authors and KAABS hope that these developing and incomplete concepts help beginners to find their own concepts.

Mondor's Disease after Immediate Breast Reconstruction with Silicone Implant

PURPOSE: Mondor's disease is commonly known as a benign breast condition after augmentation mammaplasty, and some authors have also reported its association with other breast surgeries such as reduction mammaplasty or axillary lymph node biopsy. Here we report two cases of Mondor's disease after immediate breast reconstruction with silicone implant. METHODS: Two women, 51-year-old and 36-year-old, underwent immediate breast reconstruction with silicone implants after nipple-areolar skin-sparing mastectomy. RESULTS: Subcutaneous cord-like firm lesion appeared on upper abdomen, axillary area following surgery. The lesion was painless and spontaneously subsided with no medications. CONCLUSION: To our knowledge, this is the first report of Mondor's disease developed after immediate breast reconstruction using silicone implant.

Approach to Internal Mammary Vessel without Rib Cartilage Resection in Free Abdominal Flap Breast Reconstruction

PURPOSE: The thoracodorsal vessels have been the standard recipient vessels for the majority of surgeons performing free abdominal flap breast reconstructions. Recently, the internal mammary vessels have been recommended as the first-choice recipient vessels for microvascular breast reconstruction. To approach the internal mammary vessel, 3rd or 4th rib cartilage excision is needed, but this method has some demerits such as vessel injury, post operative pain and post operative chest hollowness. So, authors propose the approach method to the internal mammary vessel through intercostal space without rib cartilage resection. METHODS: From November, 2008 to May, 2009, 13 patients underwent free abdominal flap breast reconstruction with approach to the internal mammary vessel through intercostal space without rib cartilage resection. RESULTS: The mean patient age was 41.8 years, and the mean height was 159.3 cm. 11 patients underwent immediate breast reconstruction. Free DIEP flap reconstruction was performed in 7 patients, Free TRAM flap was performed in 5 patients, and Free SIEA flap was performed in 1 patient. Except 1 case, approach to the internal mammary vessel was took through 3rd intercostal space, and all width of intercostal space exceeded 1 cm. CONCLUSION: In the authors' experience, use of approach to the internal mammary vessels without rib cartilage resection method is safe and reliable to overcome demerits of rib cartilage resection method.