{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,2]],"date-time":"2026-07-02T19:39:11Z","timestamp":1783021151955,"version":"3.54.6"},"reference-count":31,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2026,4,9]],"date-time":"2026-04-09T00:00:00Z","timestamp":1775692800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,4,9]],"date-time":"2026-04-09T00:00:00Z","timestamp":1775692800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["ANZ Journal of Surgery"],"published-print":{"date-parts":[[2026,6]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:label\/>\n                    <jats:p>Abdominoplasty is one of the most popular body contouring procedures. However, complications are common, particularly in post\u2010bariatric patients, and surgical safety is a topic of growing interest. Among the significant steps, Osvaldo Saldanha first introduced the concept of lipo\u2010abdominoplasty in 2001. Following an aggressive liposuction, the extensive dissections of traditional techniques are avoided, reducing complications. Furthermore, in 2014, Francisco Villegas advanced the TULUA technique. The latter introduces a transverse plication of rectus muscles, avoiding supraumbilical undermining, further improving safety. With the present study, we aim to introduce the TULUANHA: the modified TULUA and Saldanha lipo\u2010abdominoplasty, a new technique electively designed for post\u2010bariatric patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A retrospective study was conducted on post\u2010bariatric patients who underwent TULUANHA between January 2019 and January 2021. The TULUANHA involved a bipolar radiofrequency scalpel assisted abdominoplasty with transverse plication of rectus muscles, umbilical preservation, and extensive liposuction.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Twelve post\u2010bariatric patients matched the selection criteria and were included in the study. Minor complications occurred in 1 of 12 patients (8.3%), consisting of a seroma. No major complications were reported. According to the Salles score, all included patients revealed satisfactory aesthetic outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The TULUANHA, by combining the principles of the TULUA and the lipo\u2010abdominoplasty, a minimal supraumbilical undermining, and innovative technologies for surgical dissections, represents an innovative abdominoplasty technique. Potential benefits include enhanced vascular safety and reduced complications. Moreover, the TULUANHA allows for umbilical preservation, which is instead removed and reconstructed in the original technique. By avoiding any extensive supraumbilical dissection and related devascularization risks, the TULUANHA seems a promising technique for post\u2010bariatric patients, and future research is expected.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of Evidence<\/jats:title>\n                    <jats:p>Level V, retrospective study.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/ans.70649","type":"journal-article","created":{"date-parts":[[2026,4,9]],"date-time":"2026-04-09T07:07:29Z","timestamp":1775718449000},"page":"1566-1573","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Sculpting Success\u2014The\n                    <scp>TULUANHA<\/scp>\n                    : Modified\n                    <scp>TULUA<\/scp>\n                    Lipo\u2010Abdominoplasty in Post\u2010Bariatric Body Contouring"],"prefix":"10.1111","volume":"96","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8621-8216","authenticated-orcid":false,"given":"Gianluca","family":"Marcaccini","sequence":"first","affiliation":[{"name":"Unit of Plastic and Reconstructive Surgery, Department of Medicine, Surgery and Neuroscience University of Siena  Siena Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-6168-0853","authenticated-orcid":false,"given":"Pietro","family":"Susini","sequence":"additional","affiliation":[{"name":"Unit of Plastic and Reconstructive Surgery, Department of Medicine, Surgery and Neuroscience University of Siena  Siena Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesco Ruben","family":"Giardino","sequence":"additional","affiliation":[{"name":"Unit of Plastic and Reconstructive Surgery, Department of Medicine, Surgery and Neuroscience University of Siena  Siena Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5444-8925","authenticated-orcid":false,"given":"Ishith","family":"Seth","sequence":"additional","affiliation":[{"name":"Department of Plastic and Reconstructive Surgery Peninsula Health  Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9009-5837","authenticated-orcid":false,"given":"Yi","family":"Xie","sequence":"additional","affiliation":[{"name":"Department of Plastic and Reconstructive Surgery Peninsula Health  Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8396-095X","authenticated-orcid":false,"given":"Roberto","family":"Cuomo","sequence":"additional","affiliation":[{"name":"Unit of Plastic and Reconstructive Surgery, Department of Medicine, Surgery and Neuroscience University of Siena  Siena Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4092-182X","authenticated-orcid":false,"given":"Warren","family":"Rozen","sequence":"additional","affiliation":[{"name":"Department of Plastic and Reconstructive Surgery Peninsula Health  Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6888-2191","authenticated-orcid":false,"given":"Mirco","family":"Pozzi","sequence":"additional","affiliation":[{"name":"Unit of Plastic and Reconstructive Surgery, Department of Medicine, Surgery and Neuroscience University of Siena  Siena Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luca","family":"Grimaldi","sequence":"additional","affiliation":[{"name":"Unit of Plastic and Reconstructive Surgery, Department of Medicine, Surgery and Neuroscience University of Siena  Siena Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giuseppe","family":"Nisi","sequence":"additional","affiliation":[{"name":"Unit of Plastic and Reconstructive Surgery, Department of Medicine, Surgery and Neuroscience University of Siena  Siena Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,4,9]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.5772\/66282"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.1097\/SAP.0000000000002220"},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00266\u2010020\u201001725\u2010y"},{"key":"e_1_2_12_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cps.2014.06.006"},{"key":"e_1_2_12_6_1","doi-asserted-by":"publisher","DOI":"10.1067\/maj.2001.121243"},{"key":"e_1_2_12_7_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00266\u2010014\u20100304\u20108"},{"key":"e_1_2_12_8_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00238\u2010024\u201002195\u20100"},{"key":"e_1_2_12_9_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12262\u2010023\u201004009\u20102"},{"key":"e_1_2_12_10_1","doi-asserted-by":"publisher","DOI":"10.1093\/asj\/sjv008"},{"key":"e_1_2_12_11_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00266\u2010011\u20109776\u2010y"},{"key":"e_1_2_12_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bjps.2013.04.003"},{"key":"e_1_2_12_13_1","doi-asserted-by":"publisher","DOI":"10.14712\/23362936.2023.9"},{"key":"e_1_2_12_14_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood\u20102013\u201005\u2010427708"},{"key":"e_1_2_12_15_1","doi-asserted-by":"publisher","DOI":"10.1007\/978-3-642-66910-1_2"},{"key":"e_1_2_12_16_1","first-page":"229","article-title":"Excision of the Fat of the Abdominal Wall\u2010Lipectomy","volume":"10","author":"Kelly H.","year":"1910","journal-title":"Surgery Gynecology Obstet"},{"key":"e_1_2_12_17_1","doi-asserted-by":"publisher","DOI":"10.1097\/00000441-194212000-00014"},{"key":"e_1_2_12_18_1","first-page":"466","article-title":"Resection de la Couche adi D'obesite Extreme (Lipectomie)","volume":"3","author":"Desjardins P.","year":"1911","journal-title":"Rapport Par Dartigues"},{"key":"e_1_2_12_19_1","first-page":"341","article-title":"Traitment Chirurgicale de L'obesit\u00e9 de la Paroi Abdominale Avec Ptose","volume":"88","author":"Galtier H.","year":"1955","journal-title":"M\u00e9moires. Acad\u00e9mie de Chirurgie"},{"key":"e_1_2_12_20_1","doi-asserted-by":"publisher","DOI":"10.1093\/asjof\/ojad080"},{"key":"e_1_2_12_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jss.2021.09.035"},{"key":"e_1_2_12_22_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00266\u2010021\u201002315\u20102"},{"key":"e_1_2_12_23_1","first-page":"757","article-title":"Abdominoplasty in Mildly Obese Patients (BMI 30\u201035 Kg\/m2): Metabolic, Biochemical and Complication Analysis at One Year","volume":"29","author":"Cuomo R.","year":"2015","journal-title":"In Vivo"},{"key":"e_1_2_12_24_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11695\u2010020\u201005100\u20103"},{"key":"e_1_2_12_25_1","doi-asserted-by":"publisher","DOI":"10.1097\/00006534-196710000-00012"},{"key":"e_1_2_12_26_1","doi-asserted-by":"publisher","DOI":"10.1097\/00006534-197407001-00007"},{"key":"e_1_2_12_27_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bjps.2022.04.057"},{"key":"e_1_2_12_28_1","doi-asserted-by":"publisher","DOI":"10.3390\/jcm12010078"},{"key":"e_1_2_12_29_1","doi-asserted-by":"publisher","DOI":"10.1007\/s004640080025"},{"key":"e_1_2_12_30_1","doi-asserted-by":"publisher","DOI":"10.1080\/08941939.2021.1897714"},{"key":"e_1_2_12_31_1","doi-asserted-by":"publisher","DOI":"10.1007\/BF01570680"},{"key":"e_1_2_12_32_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00266\u2010021\u201002501\u20102"}],"container-title":["ANZ Journal of Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/ans.70649","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/ans.70649","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/ans.70649","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,2]],"date-time":"2026-07-02T18:56:58Z","timestamp":1783018618000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/ans.70649"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,4,9]]},"references-count":31,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2026,6]]}},"alternative-id":["10.1111\/ans.70649"],"URL":"https:\/\/doi.org\/10.1111\/ans.70649","archive":["Portico"],"relation":{},"ISSN":["1445-1433","1445-2197"],"issn-type":[{"value":"1445-1433","type":"print"},{"value":"1445-2197","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,4,9]]},"assertion":[{"value":"2025-01-29","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-03-18","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-04-09","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}