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Updated: May 6, 2026
In situ Transverse Rectus Abdominis Myocutaneous Flap: A Rat Model of Myocutaneous Ischemia Reperfusion Injury
Published on: June 8, 2013
The effect of hypotonic pharmacologic lipodissolution on abdominal free flap perfusion: a case report
Junggyo Seo1, Joseph Kyu-Hyung Park1, Chan Yeong Heo1
1Department of Plastic and Reconstructive Surgery, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam-si, South Korea.
Background:
Hypotonic pharmacologic lipodissolution (HPL) has gained popularity as a treatment for abdominal fat reduction, especially among Asian individuals. However, research on the effect of HPL on abdominal vascularity and abdominal autologous tissue flap are limited.
Case Description:
This case report describes a patient who underwent HPL treatment in November 2022 and subsequently underwent nipple-sparing mastectomy with free transverse rectus abdominis musculocutaneous (TRAM) flap reconstruction on April 4, 2023. The preoperative evaluation included computed tomography (CT) angiography to assess the viability of abdominal perforators and vasculature for TRAM flap reconstruction. Intraoperatively, indocyanine green (ICG) fluoroscopy was performed after TRAM flap elevation to evaluate flap perfusion. The findings revealed compromised skin-side perfusion but satisfactory deep layer perfusion, with subdermal plexus perfusion observed during de-epithelialization.
Conclusions:
These findings suggest that in nipple sparing mastectomy cases with minimal skin flap preservation requirements, a history of HPL may have less negative impact on TRAM flap reconstruction. However, in skin sparing mastectomy cases with extensive skin flap preservation needs, careful assessment, including preoperative CT angiography and intraoperative ICG imaging, is essential to minimize the risk of partial flap necrosis.
