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Neoumbilicoplasty is a useful adjuvant procedure in abdominoplasty
AA Al-shaham
BACKGROUND: Neoumbilicoplasties are indicated in congenital conditions
associated with umbilical agenesis, umbilical loss due to inflammatory
destruction, excision of skin cancer involving the umbilical stump and
in surgical procedures for herniorrhaphy, as well as in the rare condition of
umbilical endometriosis.
OBJECTIVE: Neoumbilicoplasty is an adjuvant procedure that may be necessary
during abdominoplasty with wide myofascial plication, or repair of concomitant
hernias of the abdominal wall. The present article justifies sacrificing
the umbilicus followed by neoumbilicoplasty in patients with significant wide
myofascial plication or concomitant hernias of the abdominal wall.
METHODS: Seventeen patients underwent a combination of abdominoplasty
and wide (greater than 10 cm) vertical plication of the myofascial
complex and required neoumbilicoplasty. The male to female ratio was 1:16;
mean age was 44 years, mean weight 94.1 kg and mean height 160.2 cm.
Characteristic body morphology included gross trunk obesity with a
prominent anterior abdominal wall.The female patients were multiparous.
Sacrificing the umbilici followed by neoumbilicoplasty was required in
patients with umbilical hernias and patients who had divarication of the
rectus abdominis muscles with short umbilical stumps.
RESULTS: Nine patients had concomitant ventral hernias (52.94%) and
eight patients had divarication of the rectus abdominis muscles with short
umbilical stumps (47.05%). The mean perioperative myofascial plication
distance was 15.41 cm and the gap closure required three to five rows of
sutures.
CONCLUSION: Neoumbilicoplasty is a useful adjuvant procedure during
abdominoplasty with wide myofascial plication or repair of concomitant
hernias of the abdominal wall.
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