Abdominal Contour Surgery for the Massive Weight Loss Patient
Pp. 63-78 (16)
Ulrich M. Rieger
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.
Abdominal contouring, panniculectomy, abdominoplasty, mid-body-contouring.
Department of Plastic, Reconstructive & Aesthetic Surgery, Medical University of Innsbruck, Anichstrasse 35, 6020 Innsbruck, Austria.