Long-term ultrasonographic evaluation of midline aponeurotic plication during abdominoplasty.

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.