In the last 5 years abdominoplasty has taken on a different dimension in that there has been seismic shift to less invasive techniques. In my practice we feel that results are even better and more natural with these approaches.
Combining liposuction of the upper and lower abdomen and by including liposuction of waist and hip regions along with the excess skin removal and central muscle tightening more natural results are achievable.
In this technique the tissue planes are left intact after tumescent liposuction. Hematoma and seroma formation are much less likely to occur. This also reduces the necessity for including drains. The smaller liposuction incisions are left open to drain the tumescent fluid used in the liposuction.
Liposuction of the abdomen lets the tissue planes slide more easily and therefore the amount of undermining of the lateral and upper abdomen is reduced. This helps also to reduce the discomfort post surgery and recovery time is shortened.
This new abdominoplasty technique produces excellent results in patients who have the need for fat reduction. A few years ago many surgeons were skeptical of incorporating liposuction with abdominplasty because of the fear that blood supply to the skin would be compromised. Those issues have been resolved with the use of smaller cannulas and other techniques.
Occasionally some physicians will perform this surgery with total local anesthesia similar to the total tumescent liposuction procedure. Although this is not common some physicians feel it gives much quicker recovery.