Laser Fluorescence Imaging of Vascular Territories in Lipoabdominoplasty.

[BACKGROUND] Although limited dissection is commonly thought to enhance flap perfusion during abdominoplasty, recent evidence indicates otherwise. This study used intraoperative fluorescence imaging to elucidate the dynamic role of vascular territories in ensuring flap viability.

[METHODS] Twenty consecutive women undergoing liposuction and abdominoplasty were prospectively studied, with a 100% inclusion rate. Flap perfusion was assessed immediately postoperatively using the SPY Elite System. Vascular zones were classified based on capture timing and intensity.

[RESULTS] The subcostal zone was the primary vascular contributor, perfused first and with the highest intensity. Intercostal vessels played a secondary role, whereas thoracoabdominal vessels were primary contributors in only 1 case. No complications were observed.

[CONCLUSIONS] This study highlights the critical role of the subcostal and intercostal vessels in flap perfusion after wide undermining and underscores the need to preserve these territories during abdominoplasty.