Preoperative and postoperative diagnosis: Laxity of skin and muscle of the abdomen Procedure: Abdominoplasty The 46-year-old female patient desired to have an abdominoplasty because of the lax skin, subcutaneous tissue, and muscle of her abdomen. The risks of the procedure were explained to the patient, and she signed the consent to have the procedure. When the patient presented to the operatory area, the midline of the abdomen was marked for the planned incisions. The abdomen was prepped, and 45 cc of a local infiltration of 1% Lidocaine with 1:1000000 (tel:1000000) dilution of epinephrine was administered along the planned incisional lines. A skin incision was made along the marking, which was carried through the skin and subcutaneous tissue with Bovie electrocautery. Dissection of the tissue was completed down to the fascial musculature of the abdomen. A periumbical incison was made, and the umbilical stalk was freely dissected. Additional dissection occurred, and a moderate amount of redundant skin was assessed. Using a #15 blade and Bovie electrocautery, a superior incision was made. The tissue along the upper incision was thinned, and, with hemostatis achieved, the site was irrigated with saline. Above and below the umbilicus, a plication of the rectus muscle was performed. With the patient in the semiflexed position, several tacking 2-0 Vicryl sutures were placed. An incision was then made at the iliac crest bilaterally using a #15 blade. Using Bovie electrocautery, the periumbilical area was defatted. 3-0 Vicryl sutures were used to close. On both sides, drains were placed and sutured in place. Closure was completed with additional 3-0 Vicryl sutures and subcuticuar 4-0 Vicryl sutures. 3-0 and 4-0 Vicryl sutures, followed by 5-0 nylon sutures, were used to close the periumbical area. The wound was dressed. There was approximately 55 cc of blood loss. After extubating the patient, she was transferred to the recovery area in sta ble condition

The 46-year-old female patient desired to have an abdominoplasty because of the lax skin, subcutaneous tissue, and muscle of her abdomen. The risks of the procedure were explained to the patient, and she signed the consent to have the procedure. When the patient presented to the operatory area, the midline of the abdomen was marked for the planned incisions. The abdomen was prepped, and 45 cc of a local infiltration of 1% Lidocaine with 1:1000000 (tel:1000000) dilution of epinephrine was administered along the planned incisional lines. A skin incision was made along the marking, which was carried through the skin and subcutaneous tissue with Bovie electrocautery. Dissection of the tissue was completed down to the fascial musculature of the abdomen. A periumbical incison was made, and the umbilical stalk was freely dissected. Additional dissection occurred, and a moderate amount of redundant skin was assessed. Using a #15 blade and Bovie electrocautery, a superior incision was made. The tissue along the upper incision was thinned, and, with hemostatis achieved, the site was irrigated with saline. Above and below the umbilicus, a plication of the rectus muscle was performed. With the patient in the semiflexed position, several tacking 2-0 Vicryl sutures were placed. An incision was then made at the iliac crest bilaterally using a #15 blade. Using Bovie electrocautery, the periumbilical area was defatted. 3-0 Vicryl sutures were used to close. On both sides, drains were placed and sutured in place. Closure was completed with additional 3-0 Vicryl sutures and subcuticuar 4-0 Vicryl sutures. 3-0 and 4-0 Vicryl sutures, followed by 5-0 nylon sutures, were used to close the periumbical area. The wound was dressed. There was approximately 55 cc of blood loss. After extubating the patient, she was transferred to the recovery area in sta ble condition

Using Bovie electrocautery, the periumbilical area was defatted. 3-0 Vicryl sutures were used to close. On both sides, drains were placed and sutured in place. Closure was completed with additional 3-0 Vicryl sutures and subcuticuar 4-0 Vicryl sutures. 3-0 and 4-0 Vicryl sutures, followed by 5-0 nylon sutures, were used to close the periumbical area. The wound was dressed. There was approximately 55 cc of blood loss. After extubating the patient, she was transferred to the recovery area in sta ble condition

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