The extended abdominoplasty procedure is ideal for patients with significant laxity and excess adiposity of the abdomen and flanks. These patients have substantially more tissue redundancy and excess adiposity than are seen in the full abdominoplasty patient.
The extent of the soft-tissue laxity may not extend circumferentially to merit a circumferential abdominoplasty, or the patient may simply not wish to have the additional posterior component performed.
The transverse incision of an extended abdominoplasty is longer than that of the full abdominoplasty, usually extending up to or beyond the midaxillary line.
The majority of patients who present for abdominoplasty are well suited for full abdominoplasty. The amount of excess adiposity and soft-tissue laxity in most abdominal contouring patients requires anterior resection with a transverse scar that often spans from one anterior superior iliac spine to the other, in order to avoid lateral dog-ears.
A smaller number of patients present with smaller, more localized laxity amenable to mini abdominoplasty.
At the other end of the spectrum, patients with substantial weight loss are best treated with circumferential abdominoplasty.
The extended abdominoplasty procedure therefore occupies a unique niche between full abdominoplasty and circumferential abdominoplasty.
Indications for an extended abdominoplasty include patients who are overweight or modestly obese, and those who have had significant weight fluctuations and or weight loss. These patients are concerned about the fullness of the central abdomen, as well as the fullness and laxity of the tissues in the flank area.
● Smoking
● Diabetes mellitus
● Malnutrition
● Various wound-healing disorders
● Bowel/bladder dysfunction
● Immunodeficiency
● Medications that inhibit blood coagulation
● A significant history of pulmonary or deep vein thrombosis
● Lower extremity lymphedema/venous insufficiency
● Significant medical problems including COPD/pulmonary issues, renal insufficiency, anemia, and
other systemic issues that may make abdominal tightening surgery dangerous
● Smoking cessation/avoidance of nicotine exposure for 4–6 weeks prior to surgery
● Multivitamin Daily
● Stop aspirin/other blood thinning products with primary care doctor’s permission
● Abstain from all dietary/herbal supplements not approved by the surgeon
● Basic laboratory work should be tailored to each patient. It may include CBC, Chem. 7, Factor V
Leiden, and PT/PTT/INR
● Medical clearance if needed
● Wearing abdominal binder for 2 weeks before surgery is encouraged
● Shower with a gentle antimicrobial soap the night before and day of surgery
The operative approach for extended abdominoplasty is almost identical to that for full abdominoplasty,the obvious difference is the longer transverse incision used for extended abdominoplasty. In addition to a longer transverse scar, the amount of con current liposuction needed is often greater than with a full abdominoplasty. Frequently, liposuction of the lateral chest, flanks, and hips is performed concurrently with the extended abdominoplasty.
● Maintain a partially flexed position at the waist for the first 1–2 weeks
● Wear the abdominal binder at all times except for showering
● Make sure the abdominal binder is maintained low enough on the abdomen
● Verify that there are no significant creases, folds, or drain tubes underneath the binder.
● Avoid smoking or exposure to nicotine-containing products
● Breathe deeply and use the incentive spirometer frequently
● Drink plenty of fluids
● Move legs frequently while resting, and walk regularly
● No vigorous activity or heavy lifting for 4–6 weeks