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Long-Term Follow-Up of Correction of Rectus Diastasis

Nahas, Fabio Xerfan M.D., Ph.D.; Ferreira, Lydia Masako M.D., Ph.D.; Augusto, Susy Muszkat M.D.; Ghelfond, Charles M.D.

Plastic and Reconstructive Surgery: May 2005 - Volume 115 - Issue 6 - p 1736-1741
doi: 10.1097/01.PRS.0000161675.55337.F1

Background: Correction of rectus diastasis is a procedure performed by most surgeons during abdominoplasty. The purpose of this study was to demonstrate the long-term efficacy of the correction of rectus diastasis when plication of the anterior rectus sheath is performed with a nonabsorbable suture.

Methods: Twelve female patients who underwent abdominoplasty were studied. Rectus diastasis was measured preoperatively with two computed tomographic scan slices: one above and one below the umbilicus. The bony levels where the slices were obtained served as a reference for the postoperative computed tomographic scans. During the operation, rectus diastasis was measured at the same levels as the preoperative scan slices. At the same time, the necessary force to bring the medial edge of the rectus muscle to the midline was measured with a dynamometer. Postoperative scans were obtained at 3 weeks and 6 months after the operation. A long-term follow-up scan was obtained from 76 to 84 months postoperatively for every patient.

Results: The 3-week postoperative scan proved that the correction of rectus diastasis had been achieved by the procedure. Despite the fact that there were different levels of abdominal wall resistance and that the average weight gain in this period was 6.5 kg, the long-term computed tomographic scans showed that there was no recurrence of rectus diastasis in any patient of this series, both in the superior and inferior abdomen.

Conclusions: Plication of the anterior rectus sheath with nonabsorbable suture appears to be a long-lasting procedure for correcting rectus diastasis.

São Paulo, Brazil

From the Division of Plastic Surgery, Federal University of São Paulo–EPM, and the Plastic Surgery Residency Program, Hospital Jaraguá.

Received for publication March 30, 2004; revised July 8, 2004.

Presented in part at the 71st Annual Scientific Meeting of the American Society of Plastic Surgeons, in San Antonio, Texas, November 2 to 6, 2002.

Fabio Xerfan Nahas, M.D., Ph.D., Universidade Federal de São Paulo–EPM, Disciplina de Cirurgia Plástica, Rua Napoleão de Barros, 715-4°, Andar 04024-002, São Paulo, Brazil,

©2005American Society of Plastic Surgeons