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Long-Term Ultrasonographic Evaluation of Midline Aponeurotic Plication during Abdominoplasty

de Castro, Eduardo José Passamai; Radwanski, Henrique N. M.D.; Pitanguy, Ivo M.D., Ph.D.; Nahas, Fábio M.D., Ph.D.

Plastic & Reconstructive Surgery:
doi: 10.1097/PRS.0b013e3182958ad2
Cosmetic: Ideas and Innovations
Abstract

Background: The purpose of this study was to evaluate the efficiency of the plication of the anterior rectus sheath during abdominoplasty and the anatomical characteristics of patients with recurrence.

Methods: Thirty-eight patients were selected. Patients had undergone abdominoplasty between 1 and 5 years previously. Patients were divided into two groups: group A, 18 patients who had undergone surgery 5 years previously; and group B, 20 patients who had undergone surgery 1 year before. All patients were submitted to a complete physical examination by the plastic surgeon to evaluate the abdominal wall. In addition, an ultrasound examination was performed by the same radiologist in all patients to evaluate rectus diastasis recurrence at two levels: in the supraumbilical region and in the infraumbilical region. The insertion of the recti muscles in the costal margin was also assessed. Groups were compared using Fisher’s exact test and the t test. Groups were similar regarding age, body mass index, number of smokers, physical activity, and number of pregnancies.

Results: There was no recurrence of diastasis in any cases of the group with a follow-up of more than 5 years, whereas in the 1-year follow-up group there were two cases of recurrence of the diastasis. Only one of the patients who had recurrence of rectus diastasis had a clinical complaint.

Conclusions: Recurrence of rectus diastasis is not directly related to the length of the follow-up. It may occur within the first year after abdominoplasty. Recurrence of diastasis diagnosed by ultrasound is not related to a clinical complaint.

CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, III.

Author Information

Vitória, Espirito Santo, Brazil

From Hospital Dr. Dorio Silva/Cooperativa de Cirurgia Plastica do Espirito Santo.

Received for publication June 22, 2012; accepted December 19, 2012.

Disclosure: None of the authors has a financial interest in any of the products or devices mentioned in this article.

Eduardo José Passamai de Castro Vila Velha Hospital/Cooperativa de Cirurgia Plastica do Espirito Santo Vitória, Espirito Santo, Brazil, passamai@eduardopassamai.com.br

©2013American Society of Plastic Surgeons