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Talking about minimally invasive abdominoplasty looks like a oxymoron, it is a definition that apparently contradicts itself. But how: isn't abdominoplasty a surgery that leaves a huge scar, painful, with a long and complicated recovery?

Of course it is.

But today we can completely overturn this paradigm and speak, fully, of minimally invasive abdominoplasty, or rather minimally invasive abdominoplasty techniquesthat is, an operation dedicated to patients who would normally be candidates for abdominoplasty but today can be treated with only three small incisions above the pubis. We can do this because the most advanced technology help us and thanks to the experience we have accumulated with the REPA, the minimally invasive rectus diastasis surgery, and the LESC, the subcutaneous lipoemulsion. This surgical tactic, called MILA (Minimally Invasive Lipo-Abdominoplasty) designed by the Argentine surgeon Ezequiel Palmisano (a great friend of mine) was first performed in Europe in 2021 by our own team.

Images often speak more and better than words: this is what we mean by MILA:

These photographs were taken in the operating theatre, just before starting the operation. This is a beautiful 45-year-old lady, that after two pregnancies ended up with this abdomen. In addition to a 7 cm diastasis, and a 1 cm umbilical hernia, the patient had a severely compromised abdominal adipocutaneous situation, including skin texture, as clearly visible in the preoperative photographs.

The patient underwent LESC e REPA in the same operating session, in a procedure that lasted two hours and 20 minutes.

MILA, REPA, cuccomarino

This photo was taken by the patient 10 days after surgery. As the patient lives in another region, quite far from my location, I had asked her, after the drainage was removed, to send me a picture of her abdomen, to get an idea of how the postoperative procedure was progressing. Here we can see the initial results of theminimally invasive abdominoplasty realized, and in particular the considerable improvement in the adipocutaneous panniculus of the abdomen and also in the skin texture. The patient, at the time of the photo, yet started lymphatic drainage massages but not physiotherapy, practices that are always part of the postoperative care of our patients undergoing diastasisrecti repair. The only surgical wounds are the three small incisions visible at pubic level.

MILA, REPA, cuccomarino

This is the result three months after the surgery of MILAresult that we can consider stable. The transformation of the abdomen is evident, and probably does not deserve to be commented on further; but perhaps it is worth highlighting the changes in skin texture (particularly in the periumbilical area) that are very difficult to achieve with a traditional abdominoplasty.

The patient got what she wanted: deal with a bathing season without having to be ashamed of his belly.

Our goal was much more ambitious: to impact deeply at all levels of the abdominal core (muscular, fascial, adipose, cutaneous) restoring functionality to all themas well as the aesthetic aspect. We can say that we have succeededl.

Ah, this is also a photo taken by the patient, and no filter or 'photoshopping' was used to 'tame' the final effect. We are serious surgeons.

What conclusions can we draw about minimally invasive abdominoplasty?

Abdominoplasty has played a central role in abdominal reshaping over the past decades; we can say that it has taken the lead.

In the last ten years, things have changed profoundly. On the one hand, the introduction of minimally invasive surgical techniques for the treatment of diastasis recti (such as the REPA, already considered in some guidelines - such as the Sociedad Hispanoamericana de Hernia - the gold standard for this pathology), on the other hand the development of ultrasound lipoemulsion technology (the LESC) which among its 'side effects' has that of promote the synthesis of elastic fibres in the epidermis (and thus its ability to reshape) have meant that, in experienced hands, many indications for classic abdominoplasty would be dropped. Why would our patient have had to undergo a surgical incision of over 30 cm, with a heavy post-operative and tiring recovery, if these results can be obtained with three small incisions that, if placed in a row, would measure less than 3 cm?

If you need further information, all you have to do is contact me using the following form or via WhatsAPP

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