Clinical glossary
This glossary defines the terms patients are most likely to encounter in surgical consultations and educational materials. Definitions are written for the patient who wants to understand their operation at the level of detail an attentive surgeon would use.
Terms
Abdominoplasty
Surgical removal of excess abdominal skin and fat with restoration of the abdominal wall (muscle plication when indicated). Distinct from liposuction (which removes fat without skin excision) and panniculectomy (which removes pannus only without aesthetic optimisation).
Mini Abdominoplasty
Limited abdominoplasty addressing only the infra-umbilical region — small skin excision with no umbilical repositioning. Suitable for Matarasso Type II patients (mild lower-abdominal laxity, intact upper abdominal envelope, no significant diastasis).
Standard Abdominoplasty
Hip-to-hip incision with full skin and fat envelope resection from xiphoid level to pubis, muscle plication for diastasis repair, and umbilical repositioning (neoumbilicoplasty). The default operation for Matarasso Type III–IV anatomy.
Extended Abdominoplasty
Abdominoplasty with lateral extension of the incision beyond standard hip placement — addressing flank skin laxity that pure abdominoplasty cannot reach. Often combined with flank liposuction.
Fleur-de-Lis Abdominoplasty
Combined horizontal hip-to-hip and vertical midline incisions, allowing skin removal in both dimensions. Indicated for massive weight loss patients with significant vertical (side-to-side) skin excess that horizontal-only excision cannot address.
Lipoabdominoplasty
Combined abdominoplasty with simultaneous flank/abdominal liposuction. The Saldanha technique preserves perforator vessels in the abdominal flap dissection, allowing safe combination of the two procedures in one operation.
Saldanha Technique
Modified abdominoplasty technique described by Osvaldo Saldanha that preserves the lateral perforator vessels supplying the abdominal flap. Perforator preservation maintains flap vascularity, allowing safe simultaneous liposuction. The technical foundation of modern lipoabdominoplasty.
Perforator Preservation
Surgical technique that preserves the perforating vessels of the abdominal wall during dissection — particularly important when liposuction is combined with abdominoplasty. Without preservation, combined procedures risk flap ischaemia.
Mommy Makeover
Combined abdominoplasty and breast surgery (lift, augmentation, or augmentation-mastopexy) in one or two operative sessions, addressing the changes of pregnancy and breastfeeding. Choice between single-stage and staged depends on patient health, BMI, and combined operative time.
Diastasis Recti
Separation of the paired rectus abdominis muscles along the linea alba, with intact connective tissue (no defect). Most commonly post-pregnancy. Distinct from ventral hernia (which has a true fascial defect).
Nahas Classification
Nahas's 2001 classification of abdominoplasty patients by myo-aponeurotic anatomy: Type A (diastasis from pregnancy), Type B (sheath laxity), Type C (lateral rectus insertion), Type D (poor waist definition with normal anatomy). Guides repair planning.
Matarasso Classification
Matarasso's classification of abdominal contour deformities: Type I (mild adiposity, no laxity), Type II (mild laxity below umbilicus), Type III (moderate laxity), Type IV (severe laxity above and below). Guides procedure selection.
Plication
Surgical technique of folding and suturing tissue. In abdominoplasty: suturing the medial edges of the anterior rectus sheath together to close diastasis. Two-layer plication is standard practice.
Two-Layer Plication
Plication using two layers of sutures: a first running layer (typically PDS or non-absorbable) and a second reinforcing layer. Distributes tension across two lines rather than one, improving durability.
Oblique Aponeurosis Advancement
Surgical advancement of the external oblique aponeurosis medially during abdominoplasty. Indicated for Nahas Type C (lateral rectus insertion) and Type D (poor waist definition) where standard plication alone is insufficient.
Mesh Reinforcement
Use of synthetic mesh to reinforce the muscle plication. Indicated for: massive weight loss patients with attenuated tissue, recurrent diastasis after prior repair, concomitant ventral hernia, or very wide diastasis (over 8cm).
Neoumbilicoplasty
Surgical reconstruction of the umbilicus. After standard abdominoplasty, the original umbilical position becomes inappropriate due to skin envelope shifting; a new umbilical opening is created at the correct anatomical position. Aesthetic detail matters.
Umbilicoplasty
Surgical refinement of the existing umbilicus — distinct from neoumbilicoplasty (which creates a new opening). May be performed isolated or as part of abdominoplasty refinement.
Umbilicus Reconstruction
General term for surgical creation or restoration of the umbilicus, encompassing neoumbilicoplasty after abdominoplasty, umbilical hernia repair with reconstruction, and aesthetic umbilicoplasty.
Dog Ears
Puckered tissue at the lateral ends of an abdominoplasty incision — where the curved incision meets normal skin. Usually self-limiting; persistent dog ears may require minor revision under local anaesthesia.
Seroma
Sterile fluid collection in the surgical dead space, common after abdominoplasty due to large dissection area. Managed by compression garment, drains (if used), or aspiration. Modern drainless technique with quilting sutures reduces seroma rates.
Hematoma
Collection of blood in the surgical bed. Less common than seroma but more serious — large or expanding hematomas require prompt re-operation. Identified by sudden swelling, severe pain, or drop in haemoglobin.
Compression Garment
Elastic garment worn over the abdomen post-abdominoplasty to compress the dissection space, support healing, and reduce seroma. Worn 24/7 for 4-6 weeks, then daytime weeks 6-8. Patient compliance is the most important post-operative factor for shape outcome.
Surgical Drain
Tube placed during surgery to evacuate fluid from the surgical space. Removed when output drops below threshold (typically 30cc/24h). Less commonly used in modern drainless technique.
Jackson-Pratt Drain
Specific type of closed-suction drain commonly used after abdominoplasty. Bulb compressed to create suction; collects blood-tinged fluid. Patient empties bulb daily and records output.
Progressive Tension Suture
Internal suture technique that distributes tension across multiple anchor points internally rather than at the skin closure. Reduces skin-line tension, supports drainless technique, and improves scar quality.
Quilting Suture
Internal sutures connecting the abdominal flap to the underlying fascia at multiple points, eliminating dead space. Fundamental to drainless abdominoplasty technique.
Scarpa Fascia
Membranous layer within the subcutaneous tissue of the lower abdomen. Preservation during dissection reduces seroma rates and improves scar quality — a technical detail with measurable outcome impact.
Lockwood High-Tension Closure
Closure technique placing tension on the deep fascial layer rather than the skin, reducing skin tension at the scar. Improves scar quality.
DVT Prophylaxis
Measures to prevent deep vein thrombosis post-operatively: mechanical (compression stockings, pneumatic compression devices, early ambulation) and chemical (enoxaparin, low-molecular-weight heparin). Essential in abdominoplasty due to elevated VTE risk.
VTE Risk
Risk of deep vein thrombosis or pulmonary embolism. Abdominoplasty patients have elevated baseline VTE risk due to operative duration, post-op immobility, and abdominal wall manipulation. Caprini scoring stratifies risk.
Caprini Score
Validated scoring system for VTE risk based on age, BMI, smoking, hormonal therapy, prior VTE, and other factors. Score determines prophylaxis intensity: low risk (mechanical only), moderate (mechanical + chemical), high (extended chemical prophylaxis).
Enoxaparin
Anticoagulant medication used for VTE prophylaxis post-abdominoplasty. Subcutaneous injection, typically 40mg daily for moderate-risk patients, sometimes extended post-discharge in high-risk patients.
Pneumatic Compression
Mechanical compression devices that intermittently compress the calves to promote venous return and reduce DVT risk. Used intra-operatively and post-operatively.
Early Ambulation
Walking within hours of surgery — typically 4-6 hours post-op for abdominoplasty under ERAS protocols. Reduces VTE risk, pulmonary complications, and length of stay.
ERAS Protocol
Evidence-based perioperative protocol combining: pre-op carbohydrate loading, multimodal analgesia (paracetamol/NSAIDs/regional blocks), opioid minimisation, early ambulation, and early oral intake. Reduces complications and length of stay.
TAP Block
Regional nerve block placing local anaesthetic in the plane between internal oblique and transversus abdominis muscles, under ultrasound guidance. Provides 12-18 hours of significant abdominal wall pain relief; reduces opioid requirements 50-70%.
Pannus
Hanging fold of excess abdominal skin and fat, typically extending below the pubic level. Common after massive weight loss. Pannus removal addresses functional issues (skin maceration, hygiene, mobility).
Panniculectomy
Surgical removal of the pannus only — without muscle plication, umbilical repositioning, or aesthetic optimisation. Sometimes insurance-covered for documented functional impairment. Distinct from cosmetic abdominoplasty.
BMI
Weight (kg) divided by height squared (m²). Modern abdominoplasty practice typically requires BMI under 30-32 for routine cases; case-by-case acceptance up to 35; generally declined above 35 due to elevated complication rates.
Weight Stability
Required pre-operative state — stable weight for 6-12 months before abdominoplasty. Operating before weight stabilisation produces results that don't reflect the final body. Particularly critical in post-bariatric patients.
Smoking Cessation
Mandatory pre-operative smoking cessation for at least 4-6 weeks (ideally 8-12). Cotinine testing verifies cessation. Smoking is the single largest patient-controlled risk factor for wound healing complications, skin necrosis, and overall morbidity.
Wound Dehiscence
Separation of a wound at the closure line. Risk factors: tension at closure, infection, smoking, poor nutritional status, large dissection. T-junction in fleur-de-lis abdominoplasty has highest dehiscence rate.
Skin Necrosis
Death of skin tissue due to inadequate blood supply. In abdominoplasty: typically affects the most distal flap edges (lowest blood supply). Risk factors: smoking, large dissection, tension at closure, prior abdominal surgery.
Umbilical Stenosis
Narrowing of the new umbilical opening after neoumbilicoplasty. May require minor revision in clinic. Modern technique with proper periumbilical defatting reduces stenosis rates.
Liposuction
Surgical removal of fat using suction cannulas. In abdominoplasty: combined as lipoabdominoplasty (Saldanha technique) for flank/abdominal contouring. Cannot replace abdominoplasty when significant skin laxity exists.
VASER Liposuction
Liposuction using ultrasonic energy to emulsify fat before suction. Allows finer contouring and is favoured in lipoabdominoplasty for shaping the upper abdomen and flanks. Brand of ultrasound-assisted lipo system.
FACS
Fellowship of the American College of Surgeons — international surgical credential requiring fellowship-level training, ethical review, and ongoing professional standards. Verifiable on facs.org Fellow lookup.
FEBOPRAS
Fellowship of the European Board of Plastic, Reconstructive and Aesthetic Surgery (UEMS Plastic Surgery Section). European specialty board certification, equivalent to FRCS (Plast) in the UK.
JCI Accreditation
International gold-standard hospital accreditation system requiring full equivalence with US/Western European hospital safety, infection control, and operating room standards. The default expectation for international medical tourism patients.
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