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[Reconstructive dermolipectomy of the abdominal wall. Experience with 600 cases].

Experience with 600 operations, including 200 second-look operations, for the management of lipodystrophy, fatty excess and other unsightly affections of the abdominal wall allows defining a few essential elements. The routine procedure consists in lowering the supraumbilical curtain down to the pubis after transposition of the umbilicus. This is indicated in case of considerable supraumbilical skin excess, and requires spreading the board flap with properly distributed tensions. The achievement of a beautiful curve must prevail upon the position of the scar, which is however located in the inferior abdominal crease as a rule, extending up the iliac crests. If there is less supraumbilical skin, minimal procedures can be considered, also with the major aim of obtaining a sightly curve. On a whole, it is important to emphasize that obtaining a small scar is not a goal in itself, the true hope being the restoration of a satisfactory curve of the abdominal wall.