FOR HEALTH PROFESSIONALS: HISTORY

The corset trunkplasty was created from a modified fleur-de-lis contouring technique in 2006 (see article below). Dr. Alexander P. Moya developed the modified technique in order to standardize the resection approach to allow for maximal skin removal while decreasing the risk of a major wound complication.

JPRAS modified fleur-de-lis article

"I noted that prior to this approach, my overall resection of trunk skin had a tendency to be conservative, which unfortunately left my patients with less-than-desirable body shape (see photos below).

                     BEFORE                                            AFTER
              150-lb weight loss                                       1 year
                      BMI 30

An overly aggressive approach, however, could compromise the vascular supply to the lower skin corners and lead to a moderate-sized wound. Fortunately, these wounds usually heal with local care only (see photos below)."

                   BEFORE                                     AFTER                                        AFTER
            120-lb weight loss                               6 weeks                                      4 months
                 BMI 35 1/2

The modified fleur-de-lis technique leads to a reliably-improved contouring result with a very low incidence of skin necrosis (see photos below).

                      BEFORE                                            AFTER
              120-lb weight loss                                      6 weeks
                       BMI 30

Since the procedure guarantees the lack of undermining, high-lateral incisions can be utilized to enhance the lower trunk contour (see photos below).

                      BEFORE                                            AFTER
                75-lb weight loss                                       6 weeks
                     BMI 34 1/4

It can be successfully utilized in patients with moderate abdominal skin redundancy, creating an aesthetically-pleasing lower waistline that can remain stable over the long term (see photos below).

                   BEFORE                                     AFTER                                        AFTER
            100-lb weight loss                              3 months                                    1 1/2 years
                 BMI 34 3/4

"I have performed the technique on more than 100 patients over the past several years. It has resulted in the removal of a fair amount of overhanging skin (up to 30 lbs) with a very low incidence of a major wound complication and provided a wide range of patients (BMI 19-50) with a reshaped abdomen."

Unfortunately, the downside of an aggressive fleur-de-lis can be seen along the mid-trunk, with untreated bulging excess skin of the upper abdomen and lower chest (see photos below). This mid-trunk excess skin becomes more prominent (dog ear) due to the primary vertical closure of the wide horizontal defect.

                              BEFORE                                                               AFTER
                        160-lb weight loss                                                        9 months
                             BMI 35 3/4                                                   reshaped lower waistline
                                                                                         untreated mid-trunk excess skin

The corset trunkplasty addresses this issue with a direct resection of the redundancy, which is performed in a mirror-like fashion to the lower trunk (see photos below).

LOWER CHEST RESECTION MARKINGS LOWER TRUNK RESECTION MARKINGS

"I realized that the best way to address the mid-trunk redundancy would be with a direct transverse resection that was as reliable as the lower trunk. I therefore, incorporated the same midline markings and procedural steps as the modified fleur-de-lis technique."