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Updated: Oct 17, 2025
Human Subcutaneous Adipose Tissue Sampling Using a Mini-Liposuction Technique
Published on: September 27, 2021
TULUA Lipoabdominoplasty: Transversal Aponeurotic Plication, No Undermining, and Unrestricted Liposuction. A
Francisco J Villegas-Alzate1, Guillermo Blugerman1, Javier Vera-Cucchiaro1
1From the Plastic Surgery Department, Universidad del Valle Cali; UCEVA, Central Unit of Valle del Cauca Tuluá; Centro B&S Plastic Surgery; Aesthetic and Laser Surgery Clinic; Innovare, Specialized Plastic Surgery Clinic; Division Plastic Surgery, Pontifical Catholic University of Rio Grande do Sul; Gamma Health Group, Hospital Privado Rosario; Centro de Medicina y Cirugía Plástica Esteban Elena; Plastic Surgery Department, Ain Shams University; and Department of Plastic and Reconstructive Surgery, University of Chile Clinical Hospital.
Background:
TULUA (transverse plication, no undermining, full liposuction, neoumbilicoplasty, and low transverse abdominal scar) is the acronym for a radically different lipoabdominoplasty, intended to add simplicity, improve vascular safety, and attain good results. Modifications are unrestricted liposuction, no flap detachment, massive transverse infraumbilical plication, umbilicus amputation, neoumbilicoplasty, diminished tension wound closure, and low transverse scar settlement. The objectives of this article are to describe the technique and analyze a multicenter experience.
Methods:
Sixty-eight plastic surgeons from 10 countries provided data for a retrospective review of 845 patients. Aesthetic results were scored by each surgeon using the Salles scale and analyzed in combination with complications to identify associations between patient and surgery characteristics.
Results:
Of the patients, 95.5 percent were female, 19.7 percent were obese, 35.6 percent had prior scars, 10.4 percent had undergone previous abdominoplasty, 6.5 percent were postbariatric, and 6.6 percent were smokers. One patient had a kidney transplant, and 16.5 percent had comorbidities. Surgery characteristics varied widely, being on average as follows: lipoaspirate, 2967 ml; resection, 1388 g; and surgical time, 3.9 hours; 46.5 percent were not hospitalized. Averaged results were 8.68 of 10 points, besides adequate positioning and proportion of scar and umbilicus, without epigastric compensatory bulging (4.97 of 6 points). Overall complications were 16.2 percent, mostly seroma (8.8 percent); vascular-related complications (i.e., necrosis, wound dehiscence, and infection) constituted 2.7 percent. There were no fatalities. The logistic regression model demonstrated that smoking and obesity duplicate the risk of complications; if age older than 60 years is added, the risk of complication increases seven to nine times. Reported indications were multiple; however, pathologic diastasis was excluded.
Conclusion:
TULUA lipoabdominoplasty is a new reproducible procedure with good quantified results and an acceptable complication rate.
Clinical Question/Level Of Evidence:
Therapeutic, IV.
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