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    Abdominoplasty procedure shifts tissues "back where they came from"

    Before (left) and after high lateral tension abdominoplasty in a 40-year-old female after four pregnancies. (Photographs courtesy of Ted Lockwood, M.D.)
    Las Vegas - An abdominoplasty procedure that combines the sculpting tool of liposuction with a lifting operation and shifts tissues "back where they came from" was described by its developer, Ted Lockwood, M.D., at the recent American Society for Aesthetic Plastic Surgery meeting.

    "Modern abdominoplasty techniques were developed in the 1960s," said Dr. Lockwood, aesthetic plastic surgeon in private practice and clinical assistant professor of plastic surgery at the University of Kansas Medical School, Kansas City. "The basic concept of these early procedures was that looseness or sagging of the lower abdomen was caused by a vertical relaxation or vertical drop in the tissues." These early procedures utilized wide undermining of the tissues, he added.

    "After many years of studying the anatomy of aging and relaxation of the tissues, I began to formulate some new anatomical concepts explaining how the body ages, in what directions the tissues shift as they age, and how that whole process occurs," Dr. Lockwood said.

    His studies indicated that loosening of the tissues occurs out to the sides of the body, so that a lot of the vertical loosening is along the side contours. The loose skin falls toward the middle of the stomach and towards the inner thighs from both directions. "It stops there and then it hangs," Dr. Lockwood said.

    The basic procedure that Dr. Lockwood developed and has updated treats "the entire abdominal aesthetic unit which starts from the bottom of the bra and goes to the upper thighs, all the way around, circumferentially."

    The procedure employs a standard bikini-line abdominoplasty incision that allows rejuvenation of the areas around and adjacent to the abdomen. "So that you are really producing a more complete treatment and rejuvenation of the surrounding areas," Dr. Lockwood said. "This results in a 'body lift' effect, rather than only a 'tummy tuck.'"

    A key feature of the procedure is that tissues are shifted back to their original position, which means that very little undermining is done, he said.

    This results in a technique that is much safer for healing, Dr. Lockwood said. Another advantage is that extensive liposuction can be used. "We can liposuction tissues that have not been undermined, but we can't liposuction tissues that have been undermined."

    The procedure also includes a skin resection pattern with significant lateral resection and a high-tension wound closure placed laterally. "And what is unique about the procedure is the way I close wounds," Dr. Lockwood said, "with superficial fascial system repair, which is the name that I gave this tissue." This procedure involves using the primary structural aspects of the fat. "We don't put tension on the skin - we put it all on the deeper layers so we get excellent skin scars, even though we are producing tremendous tension on the tissues."

    The procedure lifts the groin and the upper and inner thighs, and it tightens the waist, Dr. Lockwood said. "It even has an effect on the outer thigh skin and buttock position."

    For more information

    • Web site: www.tedlockwood.com
    • Lockwood T. High-lateral-tension abdominoplasty with superficial fascial system suspension. Plast Reconstr Surg 1995 Sep; 96(3):603-15.