An individualized approach to abdominoplasty in the presence of bilateral subcostal scars after open gastric bypass

摘要: Background Patients requiring surgical skin excision after massive weight loss are challenging and require an individualized approach. The characteristic abdominal deformity includes a draping apron of panniculus, occasionally associated with previous transverse scars from open gastric bypass surgery in the upper abdomen, which compromise blood supply skin. Methods We propose four different techniques for safe body contouring presence such scars: (1) limited abdominoplasty lower abdomen is performed, then completed by reversed scar positioning submammary folds; (2) one-stage procedure characterized resection island between suprapubic incisions ensured periumbilical perforators; (3) perforator-sparing selective dissection wall perforators to secure flap allow complete undermining up xyphoid process; (4) patients extensive excess skin, modified Fleur-de-Lys performed way that old transformed into vertical scar. Results treatment exemplary described. All yielded good esthetic functional results through preservation supply. Conclusion Through approach, adequate can be safely, even abdomen.