The open book abdominoplasty: a vertical scar technique for abdominal wall reconstruction in massive weight loss
1Bella Plastic Surgery, Sydney, Australia.
Objectives:
To describe the Open Book Abdominoplasty, a form of vertical abdominoplasty used in selected massive weight loss patients, and to evaluate clinical outcomes.
Methods:
A retrospective review was performed of all consecutive patients who underwent the Open Book Abdominoplasty between June 2021 and December 2024. All patients with a BMI under 35 were included in this study, with patient demographics, operative details, outcomes, and complications analysed.
Results:
53 patients were identified for this study, with 27 patients having a BMI below and 30, and 26 with a BMI between 30 and 34.9. The mean patient age was 40.5 years. The mean preoperative weight loss was 43.5 kg, with 39 patients achieving weight loss following bariatric surgery. Fourteen patients underwent Open Book Abdominoplasty alone, while 39 underwent combined procedures, including breast surgery (n=27), bra lipectomy (n=14), and belt lipectomy (n=7). The mean resection weight was 4.3 kg. The overall complication rate was 9.4%, including seroma (3.8%), haematoma (1.9%), and wound complications with delayed healing (3.8%).
Conclusions:
The Open Book Abdominoplasty is a vertical abdominoplasty technique incorporating a vertical scar for massive weight loss patients. It allows management of significant abdominal wall laxity and, when combined with adjunctive procedures, facilitates treatment of multidirectional circumferential torso excess with reproducible outcomes in appropriately selected patients.
