Background and Objective

Big abdominal deformities or abdominal surgical sequeals defy surgeon's expertise and technique. The difficulties approaching these patients are caused principally by poor skin tissue in the abdominal region, where multiple scars, adherences, retractions, traumatic and iatrogenic injuries can be found.

This paper shows different approaches to successfully classify and manage some of these difficult cases maintaining an aesthetic component to it.

Methods

We review the complex abdominal deformities presenting 3 cases that were followed throughout their evolution, which help to exemplify the pragmatic management for the treatment of complex abdominal deformities.

Results

Abdominal aesthetic surgery needs a global approach relative to the body contour. The classification of the wall deformity of complex abdominoplasties comprises an anatomical categorization, dividing the abdomen into lower, middle and upper, with or without excess skin, and provides subsequent surgical treatment. Surgical techniques have different approaches to treat the entire thoracoabdominal area by achieving reconstruction of the abdominal wall with a better result of the patient's body contour. These procedures include tissue expansion techniques, umbilical repositioning, secondary abdominoplasty, medial abdominoplasty, and reverse abdominoplasty.

Conclusions

Our proposal can treat complex abdomens through a different management approach changing strategies and preserving the basic concepts to achieve a harmonious and desi-red aesthetic result. Surgeons must be separated from the established surgical approaches incorporating other alternatives.

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