BACKGROUND: The management of severe postpregnancy musculoaponeurotic laxity remains a challenge for plastic and reconstructive surgeons. Several techniques have been proposed, but there is no consensus on the best treatment. The authors report the validity of their abdominoplasty method. METHODS: From May of 1995 to May of 2006, a retrospective chart review was conducted on 52 women who underwent the authors' abdominoplasty technique. The average age was 39 years (range, 25 to 60 years). They had an average of 3.2 children (range, two to six). The average preoperative body mass index was 23.5 (range, 20 to 31.5). None of the patients included had preexisting medical conditions. The posterior rectus fascia was released and plicated at the midline. A resorbable mesh was used to reinforce the plication and to reduce the tension of the traction. RESULTS: Follow-up ranged from 6 months to 11 years, with an average of 54 months. Complications included a bladder injury in one patient during posterior fascia release and epigastric bulging in one woman immediately after extubation. The local complications were seromas in two patients, skin flap necrosis in one smoking patient, and umbilical necrosis in one patient. Four patients required minor scar revision and liposuction under local anesthesia. There were no cases of systemic complications. No incidence of infection, dehiscence, or extrusion of the mesh was noted. All patients were completely satisfied. CONCLUSION: The release and plication of the posterior rectus sheath associated with the use of submuscular resorbable mesh is a long-lasting and reliable procedure in multiparous women with severe myoaponeurotic laxity.
BACKGROUND: The management of severe postpregnancy musculoaponeurotic laxity remains a challenge for plastic and reconstructive surgeons. Several techniques have been proposed, but there is no consensus on the best treatment. The authors report the validity of their abdominoplasty method. METHODS: From May of 1995 to May of 2006, a retrospective chart review was conducted on 52 women who underwent the authors' abdominoplasty technique. The average age was 39 years (range, 25 to 60 years). They had an average of 3.2 children (range, two to six). The average preoperative body mass index was 23.5 (range, 20 to 31.5). None of the patients included had preexisting medical conditions. The posterior rectus fascia was released and plicated at the midline. A resorbable mesh was used to reinforce the plication and to reduce the tension of the traction. RESULTS: Follow-up ranged from 6 months to 11 years, with an average of 54 months. Complications included a bladder injury in one patient during posterior fascia release and epigastric bulging in one woman immediately after extubation. The local complications were seromas in two patients, skin flap necrosis in one smoking patient, and umbilical necrosis in one patient. Four patients required minor scar revision and liposuction under local anesthesia. There were no cases of systemic complications. No incidence of infection, dehiscence, or extrusion of the mesh was noted. All patients were completely satisfied. CONCLUSION: The release and plication of the posterior rectus sheath associated with the use of submuscular resorbable mesh is a long-lasting and reliable procedure in multiparous women with severe myoaponeurotic laxity.
Authors: Rachita Sood; Lindsay E Janes; Nikita Shah; Daniel C Sasson; Marco F Ellis; Gregory A Dumanian Journal: Plast Reconstr Surg Glob Open Date: 2021-08-04