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Bilateral Pedicled Anterolateral Thigh Flap Abdominal Wall Reconstruction Following Liposuction Catastrophe: Case Report
Osama Darras, MD, PhD(c), Sara Yacoub, BA, MPH, Isaac Mordukhovich, BA, Diwakar Phuyal, MBBS, Kimberly P. Woo, MD, Michael J. Rosen, MD, Raffi Gurunian, MD, PhD, Sarah N. Bishop, MD.
Cleveland Clinic
2025-01-09
Presenter: Osama Darras, MD, PhD(c)
Affidavit:
Raymond Isakov, MD
Director Name: Raymond Isakov, MD
Author Category: Fellow Plastic Surgery
Presentation Category: Clinical
Abstract Category: General Reconstruction
PURPOSE:
Devastating abdominal injuries may result from liposuction, which can lead to necrotizing fasciitis and loss of abdominal domain. This may necessitate reconstructing the abdominal wall to improve the patient's quality of life.
METHODS:
We reported a patient who underwent abdominal wall reconstruction following liposuction-inflicted abdominal injury and necrotizing fasciitis.
RESULTS:
A 51-year-old female patient, with a sickle cell trait, developed necrotizing fasciitis due to liposuction cannula bowel perforation leading to loss of abdominal domain. This was reconstructed with a transversus abdominis release trial with a soft medium-weight mesh followed by bilateral pedicled neurotized anterolateral thigh flaps with vastus lateralis. The flaps were able to extend to the subxiphoid area by tunneling under the rectus femoris and sartorius muscles and transecting the rectus femoris vein branch. The patient's quality of life was enhanced following the surgery.
CONCLUSION:
Anterolateral thigh flaps are an excellent option that provides functional and structural abdominal wall repair. Neurotization of the muscle helps protect the muscle from atrophy. Pedicled flaps are relatively safer than free flaps in patients with sickle cell trait due to less incidence of flap thrombosis.
