Short reports and correspondence| Volume 60, ISSUE 5, P574-575, May 2007

A helpful trick for the abdominoplasty scar

Published:January 31, 2007DOI:
      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 thumbnail gr1
      Figure 1Temporary suture is placed in the middle line.
      Figure thumbnail gr2
      Figure 2Flaps are laterally tractioned and temporary clips are applied.
      Figure thumbnail gr3
      Figure 3Normally, three or four clips are necessary to distribute each flap without tension.
      Figure thumbnail gr4
      Figure 4Perfect positioning of the limbs without tension and ‘dog ears’, after suturing and removing the clips.
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