Circumferential Approach to Contouring of the Trunk

Background: Body contouring usually involves the lower and upper abdomen, flanks, hips, and back. Several techniques are available with which to achieve suitable simultaneous correction of all these aesthetic units. Objective: We review the techniques available for contouring of the trunk. Excisional procedures are abdominoplasty, abdominohemiflankplasty or extended abdominoplasty, abdominoflankplasty, and flankplasty. Indications for excisional surgery and its combination with ultrasound-assisted lipoplasty and conventional lipoplasty with excisional surgery are discussed. Methods: A series of 102 consecutive patients underwent contouring surgery of the trunk between 1998 and 2003. Detailed preoperative evaluation of the entire trunk area was performed to determine the most appropriate surgical procedure for each patient. The key surgical principles defining the technique used included high lateral tension with minimal central tension, direct limited undermining to a central triangle, discontinuous cannula undermining, and anchoring of the scar so as to avoid migration. Results: A circumferential approach to contouring of the trunk area offered excellent outcomes and a high level of patient satisfaction. Significant improvement in body contour was achieved, with a low rate of complications. Conclusions: Excisional techniques for body contouring involve major surgery that results in a relatively large scar. Carried out with maximal preoperative, intraoperative, and postoperative care, it offers a safe way to achieve significant improvement in body contour with minimal risk to the patient. (Aesthetic Surg J 2004;24:13-23)