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The abdominoplasty is one of the most frequently performed operations in the practice
of a plastic surgeon. Especially in large lipectomies the excessive tension of the
limb, and the bad positioning of the sutures can result in hypertrophic scars and
lateral ‘dog ear’ deformities, compromising the surgery and leaving surgeon and patient
unsatisfied. We use a simple trick to have an optimal distribution of the skin and
the tension of the limb, avoiding this awful complication. After the excision of the
two flaps, a temporary suture is placed in the middle line to respect the symmetry
of the future scar (Fig. 1). A skin hook is put in the lateral side of the wound and an external traction is
applied. Now with two forceps we gradually approach the flaps from the external margin
to the middle line, posing the skin in the right mode, without any tension, and we
put in a clip (Fig. 2). We put about four clips per side, depending on the size of the flaps (Fig. 3). Now we can apply reabsorbable sutures at each side of the clips, removing the clips
when finished. In this way we can easily avoid the risk of taking away and remaking
the suture, wasting time and material, if the limb is not correctly positioned (Fig. 4).
Figure 1Temporary suture is placed in the middle line.
