Reverse abdominoplasty: easily solving complicated situations.

[BACKGROUND] Epigastric tissue abundancy after abdominoplasty or liposuction is a complicated scenario that requires a precise and targeted approach. Especially when concurrent mammoplasty is planned or has already been done by the patient, a surgical operation through a submammary skin incision can solve this problem.

[AIM] To showcase our personal experience regarding reverse abdominoplasty and compare it to the state of the art.

[METHODS] To identify indications, possible complications and outcomes, detailed surgical insights as well as graphical examples are provided. In addition, our personal experience from the last four years is showcased and compared with the literature using PubMed and Cochrane Library databases with Reverse AND Abdominoplasty as search strings.

[RESULTS ] All the 12 patients operated in our facilities between 2020 and 2024 had either a pre-existing submammary scar or a plan to undergo a contestual mammoplasty; at a mean of 25,1 weeks follow up, one major complication occurred.

[DISCUSSION] There is a lack of publications on reverse abdominoplasty. Small case series are available in the literature, most of which focus on aesthetic indications. Only a few cases address the reconstructive implications of this surgical technique. In our experience, the concomitant desire or necessity of a mammoplasty and an already present inframammary scar favor the surgery. Careful recreation of a new inframammary sulcus must be considered to avoid unpleasant complications.

[CONCLUSIONS] Despite the poor literature supporting this technique, reverse abdominoplasty is a must-known procedure for successfully addressing thorny abdominal wall conditions and is characterized by consistent, replicable and safe outcomes.