Sculpting Success-The TULUANHA: Modified TULUA Lipo-Abdominoplasty in Post-Bariatric Body Contouring.

[UNLABELLED] Abdominoplasty is one of the most popular body contouring procedures. However, complications are common, particularly in post-bariatric patients, and surgical safety is a topic of growing interest. Among the significant steps, Osvaldo Saldanha first introduced the concept of lipo-abdominoplasty in 2001. Following an aggressive liposuction, the extensive dissections of traditional techniques are avoided, reducing complications. Furthermore, in 2014, Francisco Villegas advanced the TULUA technique. The latter introduces a transverse plication of rectus muscles, avoiding supraumbilical undermining, further improving safety. With the present study, we aim to introduce the TULUANHA: the modified TULUA and Saldanha lipo-abdominoplasty, a new technique electively designed for post-bariatric patients.

[METHODS] A retrospective study was conducted on post-bariatric patients who underwent TULUANHA between January 2019 and January 2021. The TULUANHA involved a bipolar radiofrequency scalpel assisted abdominoplasty with transverse plication of rectus muscles, umbilical preservation, and extensive liposuction.

[RESULTS] Twelve post-bariatric patients matched the selection criteria and were included in the study. Minor complications occurred in 1 of 12 patients (8.3%), consisting of a seroma. No major complications were reported. According to the Salles score, all included patients revealed satisfactory aesthetic outcomes.

[CONCLUSIONS] The TULUANHA, by combining the principles of the TULUA and the lipo-abdominoplasty, a minimal supraumbilical undermining, and innovative technologies for surgical dissections, represents an innovative abdominoplasty technique. Potential benefits include enhanced vascular safety and reduced complications. Moreover, the TULUANHA allows for umbilical preservation, which is instead removed and reconstructed in the original technique. By avoiding any extensive supraumbilical dissection and related devascularization risks, the TULUANHA seems a promising technique for post-bariatric patients, and future research is expected.

[LEVEL OF EVIDENCE] Level V, retrospective study.