Study on “Fleur De Lys” Muscle-Aponeurotic Plication in Abdominoplasty and Lipoabdominoplasty

Muscle-aponeurotic plication is an essential component in abdominoplasty and lipoabdominoplasty because it allows correcting flaccidity and improves abdominal wall deformity. This plication can be vertical, horizontal, or mixed. Vertical plication is the most commonly used form, although there is a growing tendency to use horizontal plication as part of the TULUA technique. We propose the mixed plication in the form of “Fleur de Lys” as a more appropriate form of correction since it corrects the vertical and horizontal flaccidity. The horizontal plication is performed perpendicular to the straight muscles and allows correcting the vertical elongation of the abdominal wall.

Material and Methods: From February 2015 to May 2019, we operated abdominoplasty and lipoabdominoplasty patients associated with the "Fleur de Lys” plication.

Results: In this period, 144 “Fleur de Lys” plications have been performed in 140 women (97.2%) and four men (2.8%), with ages ranging from 25 to 63 years (average 48 years). One hundred thirty-six cases (94.4%) were primary surgeries, and 8 cases (5.56%) were patients with previous abdominoplasty. We had no complications related to the increase in intra-abdominal pressure, only small dehiscences in 5 cases (3.5%) and seroma in 10 cases (7.8%).

Conclusion: The mixed plication technique in “Fleur de Lys” is a more anatomical manner of correcting the muscle- aponeurotic flaccidity because it fixes the vertical and horizontal flaccidity present in operated abdominoplasty and lipoabdominoplasty patients; its execution is technically easy and the results obtained are as expected, with minimal complications.