Chapter 7

Abdominal Contour Surgery for the Massive Weight Loss Patient

Ulrich M. Rieger

Abstract

Patients requiring surgical skin excision after massive weight loss are challenging and require an individualized and structured approach. The characteristic abdominal deformity includes a draping apron of panniculus often extending to the back, gluteal and thigh areas. Occasionally these deformities are associated with previous surgical scars in the upper abdomen resulting from open gastric bypass surgery or from other procedures such as open cholecystectomy. These scars can compromise the blood supply of the abdominal skin. For adequate and safe abdominal contouring both excess skin and fat as well as the remaining perfusion of the remaining tissues must be addressed to achieve satisfactory results. The key to satisfactory results is a thorough analysis of horizontal and vertical skin and fat excess of abdominal area keeping in mind the torso, buttock, flank areas and choosing an adequate and safe procedure addressing the respective areas of skin and fat excess while preserving the blood supply of the abdominal area in a scarred abdomen.

Total Pages: 63-78 (16)

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