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Cirugía Plástica Ibero-Latinoamericana

versión On-line ISSN 1989-2055versión impresa ISSN 0376-7892


VILLEGAS ALZATE, Francisco Javier. TULUA: transverse plication lipoabdominoplasty without supra-umbilical flap detachment. A series of 176 patients. Cir. plást. iberolatinoam. [online]. 2020, vol.46, n.1, pp.7-21.  Epub 25-Mayo-2020. ISSN 1989-2055.

Background and objective

Since 2005 the author has performed a fundamentally different lipoabdominoplasty to avoid complications such as necrosis, dehiscence, epigastric redundancy, high scar, bad position of the umbilicus and seromas. The modifications are: 1- unrestricted liposuction, 2- no detachment of the epigastric flap, 3- umbilical amputation, 4- lower transverse plication of the abdominal wall, 5- neoumbilicoplasty with skin graft in the ideal position and 6- low location of the transverse scar.

In this paper, we collect a large clinical serie, marking some technical aspects and evaluating the results.


A series of 176 patients with technical details and descriptive statistics is presented, measuring results with emphasis on scar and umbilicus positioning and their proportion, as well as the result of changes in waistline and epigastrium. Changes in the waist perimeter and reduction of the tension necessary for closure of the surgical wound, attributed to the transverse plication, were statistically compared.


The aesthetic results were quantified in 9.4 according to a scale (0-10). Overall, the complications were 18.7%, most of them due to incomplete graft take or delayed healing of the neoumbilicus. It was remarkably that only 1 patient presented with distal necrosis of the flap and another with partial dehiscence of the wound. Statistical differences were found in the decrease in tension for surgical wound closure and changes in waist circumference (p=0.001).


Quantified aesthetic results were high with additional advantages in terms of vascular safety, decreased wound tension, good position and quality of the umbilicus, low transverse scar location, decreased waistline and epigastric bulge correction. This technique can be simpler and safer, increasing abdominoplasty indications to a larger group of patients.

Palabras clave : Abdominoplasty; Lipoabdominoplasty; Abdominal wall; Abdominal muscles; Umbilicus.

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