Abdominoplasty in a patient with severe obesity.

Abdominoplasty and dermolipectomy are, in some cases, the only tools that a surgeon has to treat patients with severe obesity. Although liposuction is useful in removing fatty deposits without traditional surgical incisions, its application is limited in extremely obese patients. In response to current esthetic expectations, reconstructive surgeons have to deal effectively both with the actual complaint and with the desire of the patient to have an incision as small as possible. We present a case of severe obesity with large amounts of redundant skin and fat extending to below the knees. At the time of surgery, a large area of the patient's lower abdomen had become ischemic, thus making abdominoplasty the only option for treatment. We believe it is important for the surgeon be familiar with this approach because it can occur in general practice and he should be prepared to deal with it both as a relative emergency and as an elective procedure.