Our Summary

This research paper is about a common cosmetic surgery called abdominoplasty, also known as a “tummy tuck.” One common issue after this surgery is the formation of seroma, which is a pocket of clear bodily fluid that can lead to longer recovery times, more doctor visits, and sometimes additional surgery or infections. The study suggests that one way to potentially decrease the risk of seroma is by preserving a layer of tissue in the abdomen called Scarpa’s fascia during the surgery.

The researchers looked at eight studies involving 846 patients to see how preserving Scarpa’s fascia impacts the chances of seroma and the amount of fluid drained after surgery. They also looked at other outcomes like bruising (hematoma), the time it takes to remove the surgery drain, how long patients stay in the hospital, wound splitting (dehiscence), and infection rates.

The review found that keeping Scarpa’s fascia intact during the surgery was linked to less seroma, less fluid needing to be drained, quicker drain removal, and fewer infections. However, it didn’t make a difference to bruising, how long patients stayed in the hospital, or wound splitting. The researchers suggest that preserving Scarpa’s fascia should be a standard practice in tummy tucks, as it seems to reduce the chances of seroma and speed up drain removal.

FAQs

  1. What is Scarpa’s fascia and how is it related to abdominoplasty (tummy tuck)?
  2. How does preserving Scarpa’s fascia during abdominoplasty potentially decrease the risk of seroma?
  3. Does preserving Scarpa’s fascia during abdominoplasty have an impact on bruising, patient’s hospital stay duration, or wound splitting?

Doctor’s Tip

A helpful tip a doctor might tell a patient about abdominoplasty is to follow post-operative care instructions carefully, including avoiding strenuous activities and wearing compression garments as recommended. This can help reduce the risk of complications such as seroma and promote a smoother recovery process.

Suitable For

Typically, patients who are recommended for abdominoplasty are those who have excess skin and fat in the abdominal area that has not responded to diet and exercise. This can be due to factors such as pregnancy, significant weight loss, aging, or genetics. Candidates for abdominoplasty should be in good overall health, non-smokers, and have realistic expectations about the outcomes of the surgery.

Patients who have lost a significant amount of weight and have excess skin and tissue in the abdomen are also common candidates for abdominoplasty. These patients may have undergone bariatric surgery or have lost weight through diet and exercise, resulting in loose, sagging skin that can only be corrected through surgery.

It is important for patients considering abdominoplasty to consult with a board-certified plastic surgeon to determine if they are good candidates for the procedure. The surgeon will assess the patient’s overall health, medical history, and aesthetic goals to determine if abdominoplasty is the right choice for them.

Timeline

Before abdominoplasty:

  1. Consultation with a plastic surgeon to discuss goals and expectations of the surgery.
  2. Pre-operative evaluation to ensure the patient is healthy enough for surgery.
  3. Preparing for surgery by following any pre-operative instructions given by the surgeon, such as stopping certain medications or avoiding food and drink before surgery.

During abdominoplasty:

  1. Anesthesia is administered, and the surgeon makes incisions to remove excess skin and fat from the abdomen.
  2. The abdominal muscles may be tightened, and the remaining skin is repositioned to create a smoother, flatter abdomen.
  3. The incisions are closed, and the patient is monitored in a recovery room before being discharged.

After abdominoplasty:

  1. Recovery period, which may involve pain, swelling, and bruising for several weeks.
  2. Drain tubes may be placed to remove excess fluid from the surgical site.
  3. Follow-up appointments with the surgeon to monitor healing and remove sutures.
  4. Gradual return to normal activities and exercise as instructed by the surgeon.
  5. Long-term results of a flatter abdomen and improved body contour.

What to Ask Your Doctor

Some questions a patient should ask their doctor about abdominoplasty include:

  1. What is Scarpa’s fascia and how does preserving it during the surgery impact the risk of developing seroma?
  2. What are the potential risks and complications associated with abdominoplasty, including the formation of seroma?
  3. How many abdominoplasty procedures have you performed, and what is your experience with preserving Scarpa’s fascia?
  4. What is your protocol for post-operative care and monitoring for complications such as seroma?
  5. How long can I expect to stay in the hospital after the surgery, and what is the expected recovery time?
  6. What are the signs and symptoms of seroma that I should watch out for after the surgery?
  7. Are there any specific measures I can take before and after the surgery to reduce the risk of developing seroma?
  8. What is the process for draining any excess fluid that may accumulate after the surgery, and how long does this typically take?
  9. How will preserving Scarpa’s fascia impact the cosmetic results of the surgery?
  10. Can you provide me with before and after photos of previous patients who have undergone abdominoplasty with Scarpa’s fascia preservation?

Reference

Authors: van der Sluis N, van Dongen JA, Caris FLS, Wehrens KME, Carrara M, van der Lei B. Journal: Aesthet Surg J. 2023 Jun 14;43(7):NP502-NP512. doi: 10.1093/asj/sjad024. PMID: 36747469