Ultrasound-Guided Subscarpal Liposuction in Abdominoplasty: A Safe and Precise Approach for Optimized Vascular and Aesthetic Outcomes.

BACKGROUND

Subscarpal fat represents a loose, hypovascular layer that contributes to flap tension and ischemic risk in abdominoplasty. This study aimed to evaluate the safety and efficacy of ultrasound-guided subscarpal liposuction using VASER and PAL for improved vascular and aesthetic outcomes.

METHODS

A prospective, single-center comparative study was conducted on 80 patients undergoing abdominoplasty, with or without ultrasound-guided subscarpal liposuction. Key outcomes included ischemic complications, partial flap necrosis, wound healing time, and patient satisfaction (BODY-Q).

RESULTS

The ultrasound-assisted group showed a significantly lower incidence of ischemic complications (1% vs. 12%; p < 0.001) and partial flap necrosis (0% vs. 6%; p = 0.04) compared with controls. Mean wound healing time was shorter (20 ± 5 vs. 28 ± 7 days; p < 0.01), and overall satisfaction scores were higher (90% vs. 72%; p < 0.01). All procedures were completed safely without major vascular injury.

CONCLUSIONS

Ultrasound-guided subscarpal liposuction enhances vascular safety and accelerates wound healing in abdominoplasty while improving contour quality and patient satisfaction. The technique may represent a valuable adjunct to modern abdominoplasty, warranting further multicenter validation.

LEVEL OF EVIDENCE III: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .