A History of Abdominoplasty


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Abdominoplasty began in 1899 with an operation performed by Kelly who described performing a mid-abdominal incision. Since then, in the past hundred years until the present day, Abdominoplasty has evolved and changed as new techniques have developed. Thorek who operated in 1924 was the first surgeon to pioneer a technique which kept the umbilicus intact. A further advance came about in 1967 when Pitanguy published a technique called lipectomy, also known as liposuction (see below for a description and explanation). In 1972 Regnault pioneered a new technique which would advance the field of Abdominoplasty. The new way of performing Abdominoplasty that he created is called the W technique (see below for a description). In 1973 Grazer first described the Bikini line incision; this is where the incision is made within the pubic hairline. This has a number of advantages, the first is that it stops the height of the pubic hair from increasing (because the skin is being stretched upwards). The second advantage is that, unlike other incisions, the Bikini line incision means that the fat is taken out laterally which means that the tension between the two pieces of skin when they are sewn back together is equal. Then, in 1967, Callia wrote about a low incision with was placed beneath the inguinal crease. It was thought to be good because the scar rose after the operation, and in doing so also gave a small lift to the thighs. However, one of the problems with using this technique was brought to light by Grazer and Goldwyn in 1977. They reported the complication in that an incision so low did little to narrow the waist of their patients (which is something that Abdominoplasty attempts to do). In 1978 Psillakis was the first to pioneer the technique of suture plication of the oblique muscles. Through doing this he was able to create a technique which allowed him to make his patients waists far smaller than other techniques were able to. Lockwood was the next doctor to create a new technique that has become popular and is still used today. In 1995 he was the first surgeon to use the technique of placing most of the stress of the incision (where the skin is pulled tightest because of the incision) on the anterior thigh region. This means that physical change in the pubic region is minimalized and the problems of healing the wound are lessened due to the replacing of the tension. To further this, because the walls of the abdomen are less weakened than in other operations, better liposuction can be obtained which gives additional improved results. The techniques that he developed are still being used today and are being improved upon to get the best results possible.

It is interesting to note that the type of incision that is used in Abdominoplasty has changed depending on the style of Bikini that is popular at the time; during the period when the Saint Tropez style Bikini was popular, which has a very low waist cut, the incision used was horizontal to hide it behind the Bikini. However, when the French-line Bikini was popular, with a high leg cut, the incision changed once again to hide itself behind the cut of the Bikini. In recent years, the low cut Bikini has become popular once more and so the style of incision that is used has been adjusted once again.

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