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请注明名称（个人，公司，学会等等）: plastic surgery

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Objectives: abdominoplasty is not only a superficial skin correction. the abdominal fascia contributes in abdominal and waist contour. therefore, the author analyzes the different available treatments of the rectus and oblique muscle sheath

Introduction: Protrusion of the abdominal wall may occur in patients with weakness of the aponeurotic structure. The standard abdominoplasty technique uses a wide, vertically transversally and oblique oriented, plication of the rectus sheath to narrow the waistline.

Materials / method: Plications of the rectus and oblique muscle sheath are analyzed in accordance with the author experience.

Results: The rectus sheath is usually recovered with a vertical plication to reassess the correct position of the muscle. The oblique muscle is treated to improve the waist line. Mixed plications are performed when the two corrections are needed. Some authors suggested or a transverse plication of the rectus or a semilunar plication of rectus and oblique muscles.

Conclusion: The outline of the rectus and oblique muscle sheath is a significant portion of what is perceived as an aesthetic abdomen. Vertical transverse plication of the rectus sheaths with bilateral plications of the external oblique fascia retains this native form. Therefore, the anterior abdominal contour and definition are improved and an awesome improvement in waist line contour and transition from the hips to the waits is obtained.

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Objectives: In this presentation we will define the problem areas in patients who had below average results following body contouring procedures and will establish a logical approach to solve these problems.

Introduction: Body contouring procedures are frequently performed but they are not complication free. In this presentation I will share my personal approach to repair secondary body contouring deformities. Different types of deformities and their repair will be presented

Materials / method: Different types of deformities will be presented. The challenges and limiting factors will be discussed. A logical approach to each problem will be presented.

Results: Postoperative results after the correction of the deformity will be presented.

Conclusion: Repair of the secondary body contouring deformities can be challenging. One needs to define the problem and understand the limiting factors and consider a logical and low risk approach to solve these problems.

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Objectives: How to perform full legs liposuction and reshaping. Careful examination of the patient and assessment of patient expectations. Technical particularities in this indication.

Introduction: When it comes to full leg reshaping, traditional liposuction with previous or constant infiltration is mandatory. Preoperative consultation is fundamental and a good selection of patients. The technique is adapted to the quantity of fat to remove, the quality of the skin, and patients expectations and diagnose an eventual lipoedema which needs particular post operative care. I don't dissociate the buttocks from the legs to preserve harmony.

Materials / method: Photos are taken without underwear and shown to the patient, who might not have noticed an asymmetry. Fatgrafting is often associated to reshape the buttocks, legs or breast. We always start in the prone position unless we plan buttocks lipofilling. Water Assisted Liposuction, HumanMed is breaking off fat lobules by constant simultaneous isotonic infiltration with adrenaline fat is collected, rinsed, concentrated, transferred in 10 ml syringes for lipofilling when needed.

Results: For skin quality, it is better to preserve some fat under the skin and aspirate only as much as the skin can tolerate. This avoid irregularities and adherences. If there is any doubt some fat can be left behind or regrafted. In some cases we plannify a second session. Total circular legs liposuction represents a large surface of the body and postoperative pain will be proportional. Ecchymosis and edema will take time to disappear. Patient is informed about the postoperative period, Corset and double stockings are worn. The final result will be obtained after one year for total reshaping.

Conclusion: Total lower extremities reshaping combining, liposuction and lipofilling is a challenging procedure, takes a long time to perform but give the patient functional and aesthetic body contouring improvement.

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Objectives: Consider the treatment approach of the circumferential abdominal region as a result of weight loss, not bariatric surgery.

Introduction: The author's experience in the treatment of localized adiposities, as well as cutaneous flaccidity, and circumferential abdominal fascial as a result of weight loss in non-post-bariatric patients is presented.

Materials / method: A case study of more than 150 patients surgically operated in the period from January 2015 to December 2018, clinically evaluated and controlling body mass index of no more than 29, submitted to surgical treatment of their abdominal contour.
Technical and tactical details to take into account in order to avoid foreseeable complications.-

Results: Associating liposuction of predetermined areas, as well as lipectomy of the hand of the lateral postero superficial fascial treatment, as well as the plication of the abdominal midline allowed us to perform standardized lipectomies, achieving a favorable result from the point of view of abdominal tension anterior as well as its contour, and gluteal sacral region .-
Being the index of minor complications .-

Conclusion: A good clinical analysis, in a patient with a BMI less than 29, whose adipose skin flaccidity, and superficial fascial merits circumferential treatment, is of choice in order to achieve a body contour appropriate to the constitutional type of the patient to be treated.

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