Objectives: Some massive weight loss patients may present with an important skin excess in the upper and mid abdomen and pubic region and little excess in the lower abdomen. That is usually due to the constant use of a belt. Patients that already have a vertical abdominal scar may request an abdominoplasty. In both cases a long transverse scar is not need, but a mini abdominoplasty will not remove enough skin. A variation of the fleur de lis was thus developed with a limited transverse scar to remove the lower skin excess, while the epigastric and periumbilical skin is removed with the vertical incision.

Introduction: The abdominoplasty is a very common aesthetic and functional surgical procedure. Every abdominoplasty should be tailored to the patient. Most patients can be successfully treated with transverse scars of variable length and design, while some massive weight loss patients will require a "fleur de lis" excision with both a vertical and a horizontal scar. The vertical abdominoplasty is a rare procedure due to an unnecessarily visible scar.

Materials / method: The new procedure was performed on 4 male patients and 1 female patients. Four patients were treated after massive weight loss, the fifth was paraplegic due to a motorcycle accident, had a median laparotomy scar and requested an aesthetic procedure to remove as much excess skin as possible. The skin excess was marked before the procedure in standing/sitting position. The procedures were performed in the operating theatre in general anaesthesia. The undermining of the residual skin was minimal. The shape of the excised specimen resembled a fish and gave the name to the procedure.

Results: Minimal skin necrosis occurred in the paraplegic patient. The vertical scar widened in the months following surgery in the same patient and in one other male patient. No significant complications occurred in the other patients. At the last follow-up the scars were almost invisible in the male patients due to the body hair growth and overlapping on the vertical scar due to the advancement of the lateral skin flaps. In the female patient the vertical scar was more visible. At the last follow up all patients had a much better abdominal contour and were satisfied with the result.

Conclusion: The fish abdominoplasty has limited indications, but it is an easy and straightforward procedure that can provide very good results with limited morbidity and fast recovery due to the limited tension applied to the skin flaps. The pre-existent vertical scar is usually improved while the new scar in massive weight loss patients is usually inconspicuous.

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Objectives: This study presents an innovative approach to liposculpture and abdomenplasty, focusing on refining mons pubis reshaping and achieving superior aesthetic outcomes. The objective was to investigate the effectiveness of combining liposuction and fixation of mons pubis during full abdominoplasty .

Introduction: Liposculpture and abdomenplasty have gained popularity in recent years due to the increasing demand for precise body contouring and sculpting. Traditional liposuction and abdominoplasty techniques have limitations in achieving the desired level of definition . In patients with significant mons enlargement or ptosis , treatment of this area enhances the aesthetic outcome and patient satisfaction .

Materials / method: Patients undergoing liposuction and full abdomenplasty , after abdominal wall plication , mons is defatted by liposuction and sometime directly defatted by removing a wedge of fat in a deep plane . Suspension of fat and ligaments are done with continuous suturing to abdominal wall , the line parallel to incision line and if there is extra skin , it should be remove . Also care should be taken not to the incision too high , or place excess tension on wound closure as this will elevate the mons pubis to an unacceptably high position .

Results: The results of this study demonstrated significant improvements in abdominal definition and overall body contouring in patients who underwent liposculpture and abdomenplasty with mons pubis fixation and suspension . Precise fat removal and suspension led to enhanced mons appearance . Patient satisfaction rates were exceptionally high, indicating a high level of contentment with the aesthetic outcomes.

Conclusion: : During full abdominoplasty and liposuction combined defatting and suspension and fixation mons pubis represents a powerful approach to achieve superior body sculpting results . The high level of patient satisfaction and objective measurements validate the efficacy of this combined approach. Surgeons can consider integrating these techniques into their practice to offer patients precise, customized, and aesthetically pleasing outcomes

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Objectives: The objective of this talk is to depict the modern concepts of female body contouring involving patient selection, Surgical Technique, Technologies and Postop Care

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Objectives: Present an effective and safe technique for performing a combined tummy tuck with transposition of the umbilicus and the treatment of a large hernia or eventration by laparoscopy.

Introduction: A significant abdominal hernia or eventration may be present in patients requesting abdominoplasty. The treatment typically consists of offering two interventions separated by at least 6 months: the hernia cure by a visceral surgeon and then the abdominoplasty by a plastic surgeon. Publications have been made on laparoscopy repair, concomitant with abdominoplasty, of small umbilical hernias, but not large wall hernias or eventrations. We present a series of patients who have undergone, concomitantly, a laparoscopic hernia cure and an abdominoplasty with umbilical transposition.

Materials / method: A prospective series of 31 consecutive patients, operated on by abdominoplasty with umbilical transposition, course of diastasis of the rectus abdominis muscles and most often liposuction combined with the cure of a rupture of the wall under laparoscopy between 2019 and 2023 were included in the study. All the procedures were performed by the same team consisting of a plastic surgeon and a visceral surgeon.

Results: 24 patients underwent hernia treatment and 7 underwent laparoscopic eventration treatment. The surface area of the meshes ranged from 9 cm in diameter to 20 X 25 cm. Abdominoplasty with diastasis repair was performed for all patients. Umbilical transposition was performed in 29 patients and neo-umbilicoplasty in 2 cases. The follow-up of at least 6 months does not find any case of recurrence of the hernia or eventration. Diastasis ranged from 45 to 150 mm (mean 80.5 mm). Repair of a hernia or disembowelment took an average of 44 minutes (range 30 to 75 minutes).

Conclusion: We present a technique that combines laparoscopic plaque hernia repair and abdominoplasty. Particularly suitable for treating large hernias associated with abdominoplasty indications with transposition of the umbilicus and diastasis treatment, this combination makes it possible to combine two usually separate procedures in a single operating time.

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