Oscar M. Ramirez, MD, F.A.C.S. - U-M Abdominoplasty

U-M Abdominoplasty
Incisions for abdominoplasty usually are made outside the abdominal wall. Smaller incision used for a mini-abdominoplasty may be used but larger incisions to remove massive amounts of fat and skin from the abdomen usually require extensions toward the groin, thigh, or iliac areas (Figures 1 and 2). Current bathing suit designs demand incisions that are hidden inside the bikini line. This technique is referred to as the "U-M abdominoplasty." which places the incision within the preferred bikini line area.


Figure 1. Traditional W incision. This incision has a higher chance of developing "dog-ears" at the ends of the incision.		Figure 2. Slightly higher incisions will still end around the iliac areas. Any "zigzagging" of the lower incision tends to be noticeable.

Aesthetic and Surgical Considerations
The U-M abdominoplasty incision is composed of an open U and a lazy M (Figures 3 to 6). This particular design accomplishes several objectives: The length of the lower incision matches the length of the upper incision. This makes the development of "dog-ears" less likely. The final incision follows a line inside the "high-cut French" bikini line. The incision tends to lift the anterolateral thight. The incision changes the shape of the pubic aesthetic unit from triangular to oval. A triangular pubic shape usually denotes an aging pubis versus an oval shape which is the normal feature of a youthful pubis.

Figure 3. Preoperative markings. Large arrows indicate the approximate matching points for closure. Small arrows indicate the orientation of the shifting of the upper flaps.		Figure 4. Postoperative result of U-M abdominoplasty. The final incision is inside the bikini line.


Figure 5. Preoperative three-quarter view of the U-M abdominoplasty Arrows show the manual shifting of skin for final closure.		Figure 6. Postoperative result, three-quarter view, of U-M abdominoplasty.

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