VASER-Assisted Perforator-Preserving Liposuction in Full Abdominoplasty: A Prospective Study of 100 Cases

Abdominoplasty is a common cosmetic surgery to remove excess abdominal skin and fat, but combining aggressive liposuction with abdominoplasty has traditionally raised concern for compromised blood supply and flap necrosis. This study aimed to contribute the safety and efficacy profile of the combination of advanced techniques including lipoabdominoplasty and ultrasound-assisted liposuction (VASER) for aesthetic purposes in our institution.

We conducted a prospective study on 100 female patients undergoing full abdominoplasty with VASER-assisted liposuction. Aesthetic outcomes were evaluated, including the improvement in abdominal contour, waist circumference, the appearance of the umbilicus and scar, the reduction of abdominal fat thickness. Early postoperative complications (within the first 2 weeks) and late complications were recorded.

All 100 patients healed without any abdominal skin-flap necrosis. The overall local complication rate was 7% (no major complications). Minor complications included seroma in 2% (n = 2), small hematoma in 1% (n = 1), minor wound infection in 3% (n = 3), and delayed wound healing in 1% (n = 1), all managed conservatively. No patient developed deep vein thrombosis or pulmonary embolism. At 6-month follow-up, no patients had abdominal wall hernias or significant contour irregularities. All patients achieved significant aesthetic improvement in abdominal contour and were satisfied with their results.

In summary, VASER-assisted perforator-preserving abdominoplasty achieved a "dual win" of markedly improved abdominal aesthetics and maintained surgical safety. This approach represents an evolution of abdominoplasty that leverages modern technological and anatomical insights to benefit patients. We recommend that plastic surgeons consider perforator preservation as an essential principle when performing lipoabdominoplasties.

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