Objectives: Based on the new concept of skin retraction that liposuction brought to the field of plastic surgery, in the early 80thies started a new era of smaller incisions cosmetic surgery.
Many new techniques and instruments are developed to facilitate for smaller incisions. In 1989 the author developed his technique of Minimal Incision Abdominoplasty to treat rectus diastasis in patients presenting with no excess skin, incorporating previous C-section scars, without resecting any skin, avoiding long scars, dog ears and anatomical distortions.

Introduction: In 1991, while the other disciplines are embarking on endoscopy surgery, he started his research project to adapt endoscopic methods to the subcutaneous territory, that he called “Subcutaneoscopy”, to allow reduction of scar length in patients presenting with no pre-existing scars.

Materials / method: The limitations of using endoscopic methods in the subcutaneous was the absence of a natural cavity and the need of an optical space for performing video surgery, that in the subcutaneous territory it should not be created and/or maintained by the use of pressured gas, due to the risk of gas embolism and due to the gas dispersion causing a subcutaneous emphysema. In order to circumvent those risks he developed an endoscopic soft tissue dissector, called “Subcutaneous-tomo-scope” that allowed dissection of the subcutaneous tissue under endoscopic view without the use of pressured gas.

Results: He developed a series of thin retractor and transcutaneous suturing methods and suturing instruments. His first endoscopic assisted abdominoplasty was in August 1991, followed by his fully Endoscopic abdominoplasty and Endoscopic breast reduction and lifting in 1992. In 1993 endoscopy in plastic surgery was introduce for breast augmentation, brow lift, rhinoplasty, gluteal augmentation and placement of tissue expanders.

Conclusion: With 25 year experience, the author share his long term result cases and his thoughts and conclusions of the goals and limitations of minimally invasive plastic surgery and also his new achievement of bringing endoscopy abdominoplasty into another level with the use of Robotics.

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和审阅情况: 1990s

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