Outcomes of Incorporating Customized Plication in Lipoabdominoplasty Procedures

Abstract

Lipoabdominoplasty has evolved into one of the most frequently performed body contouring procedures worldwide, combining the principles of liposuction with advanced musculoaponeurotic repair to achieve superior aesthetic and functional outcomes. While traditional vertical plication effectively addresses rectus diastasis, it often fails to correct complex deformities or enhance waist definition. This has driven the development of customized plication techniques including transverse, oblique, L-shaped, and crossbow configurations that allow for individualized treatment based on anatomical classification systems and deformity severity. Preservation of abdominal wall perforators and Scarpa’s fascia underpins the safety of these procedures, maintaining robust vascularity while reducing ischemic complications and seroma formation. Contemporary evidence demonstrates that tailored plication improves waist contour, core stability, and long-term patient satisfaction without significantly increasing complication rates when performed by experienced surgeons. This review synthesizes the anatomical foundations, vascular considerations, classification of musculoaponeurotic deformities, surgical refinements, and outcome analyses of customized lipoabdominoplasty techniques, highlighting the importance of personalized approaches. Future directions include integration of advanced imaging, biomarker-based tissue assessment, and technological innovations to further optimize durability, precision, and safety.