title: Circumferential abdominoplasty for sequential treatment after morbid obesity.
abstract: BACKGROUND
  The severely obese patient, after considerable loss of weight, has large remaining skin folds. Classic transverse abdominoplasties leave bulges in the flanks. This article presents an alternative procedure, circumferential abdominoplasty, which involves the perimeter of the abdomen.
  
  
  METHODS
  Average age of the patients was 39.5 years, consisting of 10 females and two males. Incisions were made like those of the classic transverse abdominoplasty, but were extended dorsally without tension on the suture-line.
  
  
  RESULTS
  Pre and postoperative aspects revealed the huge impact achieved after resection of the excess panniculus, with improvement of body contour, posture, ambulation, social and psychological integration, hygiene and sexual performance. In some patients, seromas, partial dehiscences, flap infection and atelectasis were immediate complications. Hypertrophic scars and some remaining skin folds were late complications.
  
  
  CONCLUSIONS
  The major disadvantage of the circumferential abdominoplasty is the resulting scar. However, this procedure should be taken into consideration as an option to achieve a more harmonious body contour. Complications are not enough to contraindicate the surgery, because the patients preferred better social and professional integration, as well as behavioral improvement due to enhancement in their self-confidence.
authors.affiliation: Hospital das Clínicas, Faculty of Medicine, University of São Paulo, São Paulo, Brazil. miguelmodolin@uol.com.br
authors.forename: Miguel
authors.initials: M
authors.lastname: Modolin
authors.forename: Wilson
authors.initials: W
authors.lastname: Cintra
authors.forename: Celeste Imaculada C
authors.initials: CI
authors.lastname: Gobbi
authors.forename: Marcus Castro
authors.initials: MC
authors.lastname: Ferreira
mesh_terms: D000005:Abdomen / Q000601:surgery*; D000328:Adult; D017439:Cicatrix, Hypertrophic / Q000209:etiology; D005260:Female; D006801:Humans; D015187:Lipectomy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009767:Obesity, Morbid / Q000601:surgery*; D013529:Surgical Wound Dehiscence; D013536:Suture Techniques