TanAlethea, Veeramani Siva and Rao G Sambasiva
Introduction: Standard abdominoplasties are inadequate in addressing gross tissue excess and laxity. The Fleur De Lys technique addresses supraumbilical excess and is ideal for massive weight loss patients. However, many surgeons hold reservations with this technique because of potentially high risk of complication rates. In our experience, it is a safe technique with low complications with regard to wound healing, with a good patient satisfaction rate.
Aims: This study illustrates an effective modification of the Fleur De Lys technique by a single surgeon in our unit. We aim to share our experiences on the Fleur De Lys abdominoplasty and techniques to reduce complications.
Methodology: We described the senior author’s improvised Fleur De Lys operative technique. We obtained medical illustrations outlining pre-operative assessment and markings, and intra-operative techniques. We also discussed selection criteria. We reviewed complications and satisfaction of 29 patients who had undergone Fleur De Lys in our unit over a 3 year period.
Results: Our patient demographic showed as ratio M:F = 1:14, mean age was 39 years, mean pre-operative BMI 26.8 kgm-2 and mean tissue weight excised was 1669 Gm. 17.2% (n=5) had wound breakdown, 6.9% (n=2) developed infection and 6.9% (n=2) had seroma. Only 10.3% (n=3) patients required revision operation. Our patient satisfaction survey showed 27 out of 29 patients had a positive patient satisfaction response.
Discussion: The Fleur De Lys abdominoplasty is safe in carefully selected patients. The senior author’s improvisation ‘pinch and reduce by an inch’ technique during pre-operative skin marking placement together with a ‘no undermining’ principle intra-operatively reduces wound edge tension during closure, minimizes risk of skin flap necrosis and reduces potential dead space for fluid collection such as seroma. In our experience, this technique is safe and yields satisfactory results.