Fat necrosis and why the classic abdominoplasty should be avoided in obese patients

ABSTRACT

Major fat necrosis [more than 5 cm] is a complication rarely reported following abdominoplasty though it may be frequently seen in patients with wound dehiscence and cutaneous necrosis. In this paper, the authors report 12 cases of abdominoplasty with post-operative wound dehiscence who needed secondary skin grafting to close the wound. A review of these cases showed that extensive subcutaneous fat necrosis was a prominent feature and all the patients were obese. It appears that obese individuals are prone to develop fat necrosis postoperatively in cases where the classic abdominoplasty is used. It is important that patients reduce their weight preoperatively and avoid considering abdominoplasty as a form of weight reduction. Fat necrosis, its occurrence and the various factors that could have contributed to major wound dehiscence in these patients are discussed. The authors caution surgeons against the use of the classic abdominoplasty procedure in obese patients and s t ress minimal undermining and the use of limited dermolipectomy or apronectomy along with judicious liposuction to avoid this complication of fat necrosis