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    Corset trunkplasty safely contours massive weight loss patients' bodies


    The corset trunkplasty (Corset Body Lift) is a body contouring procedure that can effectively address the redundant skin rolls in massive weight loss patients and significantly improve abdominal and waistline contours, all while limiting complications seen with other surgical approaches, says Alexander Moya, M.D.

    "Similar to a traditional abdominoplasty and belt lipectomy, the corset trunkplasty treats the lower abdomen, but it will also target the often-neglected upper abdomen, thereby enhancing the entire waistline," says Dr. Moya, director of Geisinger's Center for Aesthetics and Cosmetic Surgery and Weight Loss Body Contouring Program, Danville, Pa.

    The lower body lift was originally designed for non-weight-loss patients, Dr. Moya says. It was then modified to the circumferential belt lipectomy to address weight-loss patients more effectively.

    Good contouring results can be difficult to achieve in those who do not fit the ideal patient model of the commonly performed belt lipectomy, he explains. In many women, the procedure will result in the lack of an aesthetically pleasing waistline.

    An alternative option, Dr. Moya developed the corset trunkplasty technique, which can be used on a wider range of patients. This includes the ideal to the more complex patient with multiple skin rolls, and it works regardless of an individual's overall body size or amount of excess skin.

    Most female patients who undergo the procedure end up with the corset trunkplasty sought-after hourglass figure, Dr. Moya says.

    HOW IT'S DONE The corset trunkplasty is performed entirely in the supine position and utilizes a standardized approach to determine the vertical abdominal resection (removal of the horizontal skin redundancy). Dr. Moya says this is key to the procedure.

    All preoperative markings are performed in the supine position once the patient is prepped and draped and include the vertical midline (extending from xiphoid down to the pubis), lower chest (extending from side-to-side, following the inframammary folds in women) and pubic reference lines.

    According to Dr. Moya, the vertical resection is determined in a very routine manner utilizing a simple tailor-tacking technique. This allows for maximum skin removal while guaranteeing closure of the defect without undermining.

    The horizontal skin redundancy extending from the lower chest to flanks is pulled tightly together towards the midline, inverted, and temporarily stapled. In this way, Dr. Moya can more accurately assess how much skin can be removed from the chest down to the pubis, he explains.

    The stapled skin is then marked and released. The marked areas are connected to one another on each side and to the top and bottom of the preoperative midline marking to form a vertical ellipse shape.

    This redundant skin pattern is directly resected off the underlying muscular fascia, temporarily resulting in a large defect that will often encompass the entire abdominal wall. Any ensuing abdominal wall plication can then be easily performed due to the extent of exposure, Dr. Moya says. This step not only enhances overall contour, but also facilitates primary closure without undermining by reducing the size of the vertical defect, he explains. This aggressive resection of horizontal skin redundancy followed by simple primary closure provides the greatest improvement in abdominal and waistline shape while limiting wound complications.



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