The long-term durability of plication of the anterior rectus sheath assessed by ultrasonography
ABSTRACT The purpose of this study was to assess the long-term durability of a standard vertical plication of the anterior rectus sheath. For this purpose, 70 women who had undergone this procedure as part of an abdominoplasty were sent a questionnaire, their records were studied, and they were invited back to the clinic for an examination using ultrasound. A total of 63 patients returned the questionnaire, and 40 were willing to attend a follow-up consultation and ultrasound investigation. The presence of rectus diastasis was assessed by ultrasound (a real time scanner with a 7.5-MHz linear probe). The study showed that after a follow-up of 32 to 109 months (mean, 64 months), standard plication of the abdominal wall with absorbable material led to residual or recurrent diastasis in 40 percent of the patients. It also confirmed that vertical plication only is not enough to improve the waistline and may eventually lead to epigastric bulging.
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ABSTRACT: In 10 cases of abdominoplasty where an important rectus diastasis had to be corrected, we completed the plication of the rectus sheath included in a classical abdominoplasty with the laparoscopic positioning of an intraperitoneal prosthesis. Purpose To assess the middle-term results of this technique and present its advantages and drawbacks. Patients and method Fifteen patients have been operated from 2007 to 2011 by two surgeon teams. Ten of them have accepted to be included in our survey. Results All the patients said they were satisfied with their surgery. Four of them reported mild pain during the first postoperative weeks, and two of them mentioned very moderate pain at the time of the survey. The surgeons were not satisfied with the results obtained in two cases. Only one of these two patients accepted revision abdominoplasty with a good result. Conclusion Laparoscopic positioning of an intraperitoneal prosthesis, coupled with a classical plication of the rectus sheath, gives excellent results in difficult cases of rectus diastasis.Annales de Chirurgie Plastique Esthétique 08/2012; DOI:10.1016/j.anplas.2011.08.011 · 0.59 Impact Factor
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ABSTRACT: Liposuction abdominoplasty-liposuction of abdominal subcutaneous tissue deep and superficial to Scarpa's fascia, with excision of excess abdominal skin and, when indicated, plication of the anterior rectus sheath without undermining-is an effective, low-risk approach to minimizing abdominal flap undermining. The technique allows aggressive thinning and "sculpting" of full-thickness abdominal subcutaneous tissue and achieves a natural (not featureless) abdominal contour. It minimizes the creation of "dead space," which often leads to postoperative complications, as well as preserves sensory nerve and blood supply to the abdominal skin. The operation may be performed with the patient under local anesthesia, which probably diminishes the risk for deep vein thrombosis. Moreover, additional procedures can be conducted safely and the postoperative course is short, uneventful, and without restrictions; patients return to normal activity within a week or so. New evaluation criteria for abdominoplasty are discussed in this article, the most important of which is the assessment of intraabdominal fat content and its impact on surgical outcome and the decision to perform anterior rectus sheath plication. The concept of a sliding, mobile, sensate abdominal flap, created by liposuction and sustained by multiple neurovascular mesenteries, is also offered.Plastic & Reconstructive Surgery 08/2003; 112(1):288-98; discussion 299-301. DOI:10.1097/01.PRS.0000066371.34978.F0 · 3.33 Impact Factor
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ABSTRACT: The aponeurotic layer is a very important element to consider during abdominoplasty. For most patients, a simple midline plication is enough to obtain good results. However, for in patients with severe aponeurotic laxity, some other maneuvers must be performed. The purpose of this study was to evaluate the use of polypropylene mesh in this group of patients. We analyzed the results for 20 patients in whom three types of mesh anchoring were used on the basis of intraoperative findings. Adequate long-term follow-up results were obtained, with no recurrence of rectus diastases, as shown by ultrasonography.Aesthetic Plastic Surgery 06/2004; 28(3):144-7. DOI:10.1007/s00266-004-3124-4 · 1.19 Impact Factor