Scarpa fascia versus rectus sheath plane in Lipoabdominoplasty flap dissection: Comparative study.

Background: Abdominoplasty and lipoabdominoplasty are frequently performed aesthetic procedures to improve the contour of abdomen and flanks. The improvement obtained would positively impact patient’s self-image and life quality. A lot of potential complications would compromise surgeon/patient satisfaction, the most frequent being seroma formation. A lot of measures/techniques were advocated to reduce seroma incidence including the use of suction drain, dead space obliteration by quilting sutures, and preservation of infraumbilical Scarpa fascia/deep fat layer. The latter is the focus of the current comparative study. Patients and Methods: 40 full lipoabdominoplasty cases were randomized into 2 equal groups based on infraumbilical dissection plane. Group A with traditional rectus sheath dissection plane and group B with supra Scarpa dissection plane. Post-operative drainage volume, time of drain removal and incidence of symptomatic seromas were documented. Results: Drainage volume and duration of drainage were significantly lower in supra Scarpa dissection group (B) than those of rectus plane group (A) (p < 0.001). Clinically evident seroma was detected in 3 cases of group (A) and in one case of group (B). All resolved after 2-3 aspirations in outpatient settings. Both groups were homogenous regarding BMI, age, volume of lipoaspirate, weight of excised dermofat and mean operative time. Conclusion: Scarpa fascia/deep fat preservation significantly reduced the drainage volume and duration. A lower seroma incidence was also observed.Key Words: Scarpa fascia, Lipoabdominoplasty, Seroma.