Một bệnh nhân loại 3 đã vượt quá da nhẹ, bụng dưới lỏng lẻo với diastasis recti và nhẹ đến trung bình loạn dưỡng lipid thấp hơn để rốn. Ngoài việc cắt bỏ da và hút mỡ placation của vỏ rectus từ pubis để rốn là bắt buộc. | 156 24 The Modern Lipoabdominoplasty tion with liposuction is effective for these patients. A type 3 patient has mild skin excess lower abdominal laxity with diastasis of the recti and mild to moderate lipodystrophy inferior to the umbilicus. In addition to the skin resection and liposuction placation of the rectus sheath from the pubis to the umbilicus is required. A type 4 patient has skin excess significant laxity of the musculoaponeurotic layer and lipodystrophy. Skin resection liposuction and plication along the entire rectus sheath offers improvement but may require transaction of the umbilical stalk. A type 5 patient presents with severe upper and lower abdominal skin excess and laxity. Diastasis of the recti is severe and the patient is often moderately obese. Traditional standard abdominoplasty with placation of the rectus sheath and defatting is necessary. Surgical Technique Preoperative Treatment Aesthetic improvement of the abdomen is achieved with a continuum of procedures ranging from liposuction alone to multistage belt lipectomy with repair of musculo-fascial defects. Modern abdominoplasty is a concept-oriented procedure to address lipodystrophy musculoaponeurotic laxity and redundant skin Fig. . It combines aggressive liposuction of the abdomen and flanks with dermolipectomy in the suprapubic region. Undermining is limited to the midline to allow placation of the fascia. Preoperative evaluation and markings Fig. are made with the patient in the standing position. The anticipated area for skin resection is marked as are the areas for liposuction. Prior to induction of general anesthesia lower extremity compression devices are placed and preoperative antibiotics are given. Once the patient is asleep and the Foley catheter has been placed several small access incisions are made. Usually these are placed at the umbilicus the top of the pubic hairline and laterally within the bikini or underwear line to minimize visible scaring .
