TULUA: Effects of Flap Undermining and Type of Wall Plicature in a Rat Model Abdominoplasty.

[BACKGROUND] TULUA, a transverse plication lipoabdominoplasty, which excludes elevation of the supraumbilical flap and includes a skin graft neoumbilicoplasty, claims greater safety and better results. An animal study was designed to compare it, with two current techniques.

[MATERIALS AND METHODS] Three matched groups of 12 rats had combined liposuction and abdominoplasty. Liposuction was extensive and unrestricted. Groups 1 and 2 had vertical plication and transposition umbilicoplasty, and group 3 had transverse plication and neoumbilicoplasty. Flap elevation in the epigastrium was wide to costal margins in group 1, limited to a tunnel in group 2, and no dissection in group 3. The animals were observed for 21 days and then euthanized. Intraoperative, postoperative, and postmortem variables and findings were measured and analyzed to find differences between groups.

[RESULTS] Transverse lipoabdominoplasty demonstrated a wider wall plication area, as well as a decrease in tension to close the wound, causing the horizontal scar to remain in a low position. In vertical plication lipoabdominoplasty groups, flap necrosis and seromas were more frequent, and the umbilical position descended due to secondary healing and scar contraction. The scar's scores were better in the transverse group and were confirmed when evaluated by external observers.In postmortem examination, horizontal plication presented less widening; perforator vessels were preserved when surgical undermining of the upper abdomen was not performed, and there were fewer seromas.

[CONCLUSION] In a rat model, TULUA demonstrates superior results and a decrease in complications when compared to lipoabdominoplasties with vertical plication and wide or tunneled dissection in the upper abdomen.

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