Waist Reducing Abdominoplasty. Do We Save Lives?

Purpose: Waist circumference has been positively associated with increased mortality rate in a large number of studies. Moreover, large waist is linked to poor health even among people with normal BMI and is possibly related to specific cancers (e.g. postmenopausal breast cancer). We present our waist reducing abdominoplasty technique.

Material & Methods: From May 2010 to March 2017 we performed 208 abdominoplasties. We incorporated four waist reducing maneuvers in our abdominoplasty technique as following:

• One incision aggressive liposuction technique to the flanks using ultrasound assisted liposuction. The marking is different than the traditional one. We mark 4 different triangles based in anatomical landmarks. We perform different level liposuction to the upper triangles than to the lower ones and as the marking resembles the wings of a butterfly we named it after it as the Butterfly technique.
• Strong plication of the rectus sheath.
• Inferior and medial advancement of the abdominal flaps during closure.
• High Tension Stitches to central and lateral abdominal flap.

Waist circumference has been measured at the midpoint between the lower margin of least palpable rib and the top of the iliac crest. The measurement has been taken with the patient standing, naked and at the end of normal exhale.

We measured the waist circumference before the operation and 6 months after the procedure. Patients were categorized in 3 groups regarding the BMI: Group I BMI from 18.5-24.9, Group II BMI 25-29.9 and Group III with BMI = 30. Patients were also requested to evaluate their aesthetic results in a 5-scale climax (poor, fair, good, very good, excellent).

Results: Reduced waist circumference was recorded in all patients.

Group I had a mean reduction of W.C. of 5cm (2cm to 12cm)

(185 patients),

Group II had a mean reduction of W.C. of 8.5cm (5-17cm)

(20 patients) and

Group III had a mean reduction of W.C. of 11cm (9-21cm)

(3 patients)

75% of the patients marked their results as excellent, 15% as very good and 10% good.

                                                             

Conclusion: It has been documented that men and women with large waist circumference have lower life expectancy. We describe an abdominoplasty technique which can specifically reduce waist circumference and could offer them important health benefits and probably lower mortality rates.