RISKS AND POSSIBLE COMPLICATIONS OF COMBINED ABDOMINOPLASTY “FLEUR-DE-LIS” FROM THE POINT OF VIEW OF STEP-BY-STEP TREATMENT OF PATIENTS WITH AESTHETIC DEFECTS OF THE ABDOMINAL WALL WITH CONCOMITANT METABOLIC SYNDROME

Abdominoplasty using the "fleur-de-lis" method is a complex reconstructive and aesthetic procedure used in patients with severe abdominal wall defects, particularly after massive weight loss.The presence of metabolic syndrome, which includes obesity, insulin resistance, arterial hypertension, and dyslipidemia, significantly increases the risk of postoperative complications.The presented clinical case shows a 68-year-old female patient with a BMI of 36.2 kg/m and decompensated type 2 diabetes mellitus who underwent combined abdominoplasty.In the early postoperative period, complications arose in the form of seroma, requiring multiple punctures under ultrasound guidance, as well as areas of skin necrosis in the T-shaped suture area.The prolonged healing process required step-by-step local treatment with antiseptics, anti-inflammatory drugs, and regular dressings.Despite positive dynamics, recovery was delayed, indicating the impact of metabolic disorders on the postoperative period.The results obtained emphasize the importance of careful preoperative assessment of patients with metabolic syndrome, correction of glycemia and concomitant pathologies before major plastic surgery.A multidisciplinary approach involving an endocrinologist, cardiologist, and surgeon is critical to reducing the risk of flap necrosis, infectious complications, and prolonged rehabilitation.Thus, this case illustrates that metabolic syndrome is a significant risk factor in "fleur-de-lis" abdominoplasty and requires a special patient management strategy to achieve safe and predictable results.