Analysis of Extended Deep Fat Pad Excision in Abdominoplasty.

Background: Because abdominoplasty flap's major vascularization is suprafascial, some surgeons perform excision of the deep fat pad below Scarpa's fascia to achieve a better abdominal contour and balance the lower abdominal projection above and below the scar. The dimensions of this excised adipose flap and its correlations to both the classic abdominoplasty flap and patient biometrics have not been studied yet and are the aim of this article. Short-term complication outcomes are also reported.

Methods: We performed a prospective case series study, operating 74 consecutive women using an otherwise standard abdominoplasty technique, and recorded patient variables, flap dimensions, and complications.

Results: Average values are as follows: BMI, 27.35 kg/m; total flap weight, 1868 g; adipose flap weight, 157 g (corresponding to 9% extra flap weight); adipose flap height, 7.2 cm; and preserved infraumbilical deep fat pad thickness, 7.7 mm. Statistical analysis of correlations between variables was performed.

Conclusions: Increased patient weight, umbilical perimeter, BMI, and width of the operative specimen can be used to predict a heavier extra adipose flap. The extra fat excision is safe, preventing inadvertent invasion of the abdominoplasty flap's suprafascial plane that can happen with liposuction. No flap necroses were observed. The use of this technique may prove useful to achieve a slimmer abdominal contour and harmonize it with the pubic region.