The Triangular Technique for Abdominal Myofascial Plication | ||||
The Egyptian Journal of Plastic and Reconstructive Surgery | ||||
Article 8, Volume 45, Issue 2, April 2021, Page 105-112 PDF (18.93 MB) | ||||
Document Type: Original Article | ||||
DOI: 10.21608/ejprs.2021.173870 | ||||
View on SCiNiTO | ||||
Authors | ||||
Mohamed S. M. Hassan 1; Wael Naeem Thabet Ghebery2 | ||||
1The Department of Plastic Surgery, Faculty of Medicine, Fayoum University Egypt | ||||
2The Department of Plastic Surgery, Faculty of Medicine, Cairo University, Egypt | ||||
Abstract | ||||
Introduction: Abdominoplasty has two fundamental principles: First: Removal of excess fat and skin from the abdominal wall. Second: Narrowing of the waistline. Myofascial plication is a fundamental part of abdominoplasty that is done by most surgeons to reinforce the weakened abdominal wall and to produce a narrow waistline. Despite many techniques were depicted for abdominal wall plication, there is no general agreement among plastic surgeons about the ideal technique. In this article, the authors demonstrate and evaluate the triangular technique for myofascial plication. Patients and Methods: Between January 2019 and February 2020, the authors applied the triangle plication technique on 19 women with rectus muscle diastasis who underwent anterior abdominal wall plication as a part of conventional abdominoplasty. The patients were followed-up for 7-12 months post-operative. The results were assessed mainly by measuring the reduction in the waist to hip ratio, the patients' satisfaction on a scale of 0 to 10, and by an external observer using the Global Aesthetic Improvement SCORE (GAIS). Results: Patients' satisfaction were graded as excellent in 95% of cases and the GAIS ranged between scores 4-5 in 95% of cases with 17.3% average reduction in the ratio of waist to hip measures and 19.3% average reduction of the vertical length of the rectus sheath. Conclusion: Abdominal myofascial triangular plication is a simple technique that results in improvement of the trunk contour with a narrower waistline, facilitates tension-free closure of abdominoplasty incision, and with high patients' satisfaction rates. | ||||
Keywords | ||||
Abdominoplasty; Myofascial; Plication; Triangle technique | ||||
References | ||||
Gutowski K.A.: Evidence-Based Medicine: Abdominoplasty. Plast. Reconstr. Surg., 141 (2): 286e-99e, 2018. 2- Netscher D.T., Wigoda P., Spira M. and Peltier M.: Musculoaponeurotic plication in abdominoplasty: How durable are its effects? Aesthetic Plast. Surg., Dec. 19 (6): 531- 4, 1995. 3- Nahas F.X., Augusto S.M. and Ghelfond C.: Should diastasis recti be corrected? Aesthetic Plast. Surg., Aug. 21 (4): 285-9, 1997. 4- Nahas F.X. and Ferreira L.M.: Concepts on Correction of the Musculoaponeurotic Layer in Abdominoplasty. Clin. Plast. Surg., Jul. 37 (3): 527-38, 2010. 5- Yousif NJ, Lifchez SD, Nguyen HH. Transverse rectus sheath plication in abdominoplasty. Plast. Reconstr. Surg., Sep. 1; 114 (3): 778-84, 2004. 6- Marques A., Brenda E., Pereira M.D., de Castro M. and Abramo A.C.: Abdominoplasty with two fusiform plications. Aesthetic Plast. Surg., Jun. 20 (3): 249-51, 1996. 7- Abramo A.C., Casas S.G., Oliveira V.R. and Marques A.: H-Shaped, double-contour plication in abdominoplasty. Aesthetic Plast. Surg., Aug. 23 (4): 260-6, 1999. 8- Sozer S.O. and Agullo F.J.: Triple Plication in Miniabdominoplasty. Aesthetic Plast. Surg., Jun. 30 (3): 263-8, 2006. 9- Soares Filho I.: Abdominal wall treatment with plication using the crossbow technique. Rev. Bras Cir Plástica RBCP - Braz J. Plast. Sugery, 34 (1): 23-30, 2019. 10- Nahas F.X., Faustino L.D. and Ferreira L.M.: Abdominal Wall Plication and Correction of Deformities of the Myoaponeurotic Layer: Focusing on Materials and Techniques Used for Synthesis. Aesthet Surg J., Mar. 14; 39 (Supplement 2): S78-84, 2019. 11- Desie N., Willems A., De laet I., Dits H., Van Regenmortel N., Schoonheydt K., et al.: Intra-abdominal pressure measurement using the FoleyManometer does not increase the risk for urinary tract infection in critically ill patients. Ann. Intensive Care, Dec. 2 (S1): S10, 2012. 12- Ferreira L.M., Castilho H.T., Hochberg J., Ardenghy M., Toledo S.R., Cruz R.G., et al.: Triangular mattress suture in abdominal diastasis to prevent epigastric bulging. Ann. Plast. Surg., Feb. 46 (2): 130-4, 2001. 13- Delorenzi C., Weinberg M, Solish N. and Swift A.: A Multicenter Study of the Efficacy and Safety of Subcutaneous Nonanimal Stabilized Hyaluronie Acid in Aesthetic Facial Contouring: Interim Report: SUBCUTANEOUS RESTYLANE. Dermatol. Surg., Mar. 15; 32 (2): 205-11, 2006. 14- Strigård K., Clay L., Stark B. and Gunnarsson U.: Predictive Factors in the Outcome of Surgical Repair of Abdominal Rectus Diastasis: Plast. Reconstr. Surg. - Glob Open, May 4 (5): e702, 2016. 15- Oneal R.M., Mulka J.P., Shapiro P., Hing D. and Cavaliere C.: Wide abdominal rectus plication abdominoplasty for the treatment of chronic intractable low back pain. Plast. Reconstr. Surg., Jan. 127 (1): 225-31, 2011. 16- Elkhatib H., Buddhavarapu S.R., Henna H. and Kassem W.: Abdominal musculoaponeuretic system: Magnetic resonance imaging evaluation before and after vertical plication of rectus muscle diastasis in conjunction with lipoabdominoplasty. Plast. Reconstr. Surg., Dec. 128 (6): 733e-40e, 2011. 17- Tadiparthi S., Shokrollahi K., Doyle G.S. and Fahmy F.S.: Rectus sheath plication in abdominoplasty: Assessment of its longevity and a review of the literature. J. Plast. Reconstr. Aesthet. Surg., Mar. 65 (3): 328-32, 2012. 18- Ceydeli A., Rucinski J. and Wise L.: Finding the best abdominal closure: An evidence-based review of the literature. Curr. Surg., Mar. 62 (2): 220-5, 2005. 112 Vol. 45, No. 2 / The Triangular Technique for Abdominal Myofascial Plication 19- Stewart K.J., Stewart D.A., Coghlan B., Harrison D.H., Jones B.M. and Waterhouse N.: Complications of 278 consecutive abdominoplasties. J. Plast. Reconstr. Aesthet. Surg., Nov. 59 (11): 1152-5, 2006. 20- Serra-Renom J-M., Martinez-Teixido L. and Serra-Mestre J-M.: Abdominoplasty with Customized Transverse Musculoaponeurotic Plications: Plast. Reconstr. Surg., Dec. 136 (6): 741e-9e, 2015. 21- Staalesen T., Olsén M.F. and Elander A.: The Effect of Abdominoplasty and Outcome of Rectus Fascia Plication on Health-Related Quality of Life in Post-Bariatric Surgery Patients: Plast. Reconstr. Surg. Dec. 136 (6): 750e-61e, 2015. 22- Al-Basti H.B., El-Khatib H.A., Taha A., Sattar H.A. and Bener A.: Intraabdominal pressure after full abdominoplasty in obese multiparous patients. Plast. Reconstr. Surg., Jun. 113 (7): 2145-50; discussion 2151-2155, 2004. 23- Mahmoud N.A. and Abdel Hamid W.R.: Assessement of the Correction of Rectus Abdominis Muscles Diastasis Using Two Different Techniques. Egypt J. Plast. Reconstr. Surg., Jul. 1; 43 (2): 271-82, 2019. 24- Hassan M.: Modification of Rectal Myofascial Repair in Abdominoplasty for Patients with Widely Divaricated Recti. Egypt J. Plast. Reconstr. Surg., Oct. 1; 43 (3): 539- 44, 2020. 25- Tercan M., Bekerecioglu M., Dikensoy O., Kocoglu H., Atik B., Isik D., et al.: Effects of abdominoplasty on respiratory functions: A prospective study. Ann. Plast. Surg., Dec. 49 (6): 617-20, 2002. 26- Watson R.A. and Howdieshell T.R.: Abdominal Compartment Syndrome: South Med. J. Apr. 91 (4): 326-32, 1998. 27- Pereira N., Sciaraffia C., Danilla S., Parada F., Asfora C. and Moral C.: Effects of Abdominoplasty on Intra- Abdominal Pressure and Pulmonary Function. Aesthet. Surg. J., Jun. 36 (6): 697-702, 2016. 28- Wilhelmsson S., Fagevik Olsén M., Staalesen T., Elander A. and Nygren-Bonnier M.: Abdominal plasty with and without plication-effects on trunk muscles, lung function, and self-rated physical function. J. Plast. Surg. Hand Surg., Jun. 51 (3): 199-204, 2017. 29- Rodrigues M.A., Nahas F.X., Gomes H.C. and Ferreira L.M.: Ventilatory function and intra-abdominal pressure in patients who underwent abdominoplasty with plication of the external oblique aponeurosis. Aesthetic Plast. Surg., Oct. 37 (5): 993-9, 2013. 30- Bragg T.W.H., Jose R.M. and Srivastava S.: Patient satisfaction following abdominoplasty: An NHS experience. J. Plast. Reconstr. Aesthet. Surg., Jan. 60 (1): 75- 8, 2007. | ||||
Statistics Article View: 237 PDF Download: 720 |
||||