Open surgical abdominoplasty with repair of rectus abdominis muscle diastasis using the Abrahamson technique (with video)
Year: 2025
Type: article
Study design: Case Report
Abstract: en anglais Aesthetic enhancement of the abdominal wall is a frequent reason for consulting a plastic surgeon. Abdominoplasty uses a large horizontal scar to remove excess abdominal fat and skin above or below the umbilicus, often resulting from significant weight loss. It can also be used to correct diastasis of the rectus abdominis muscles, which corresponds to the abnormal separation of the two rectus muscles, separated by the linea alba [ 1 ]. Although its exact prevalence is not clearly known, it is a pathology very frequently encountered in plastic surgery, giving a globular and distended look to the abdomen. A classification into four types has been described, based on the distance between the two rectus muscles [ 2 ]. Pregnancy, obesity and diabetes have been cited as risk factors, as they increase intra-abdominal pressure and distend the abdominal wall. To achieve the best possible aesthetic result, diastasis must be corrected, ranging from simple suturing of the anterior aponeuroses of the rectus abdominis muscles to more complex aponeurotic plasty procedures or even prostheses. In this video, we present the case of a 46-year-old patient with a type D abdominal diastasis, measured at 7 cm, following three pregnancies. This was associated with moderate abdominal skin excess, requiring concomitant skin resection (Fig 1.). We performed a large abdominoplasty with transposition of the umbilicus and cure of diastasis of the rectus abdominis muscles using the technique described by Abrahamson in 1988 [ 3 ] (Fig 2.). This involves creating a new linea alba using an overlap suture between the two anterior aponeuroses of the muscles (Fig 3.). The two lateral parts of the aponeuroses are sutured to this central “beading”, thus reducing the gap between the two muscles (Fig. 4.). Postoperatively, the patient had to wear an abdominal girdle and refrain from carrying heavy loads for three months. She had no complications. At the end of the video, we present the early postoperative result. The Abrahamson technique enables the correction of large diastasis of the rectus abdominis muscles stronger than the simple plication of the anterior aponeuroses and above all without the use of prosthetic reinforcement.
Source: Surgery Open Digestive Advance
Institution: Hôpital d'Hautepierre
Language: English
Topic: Body Contouring and Surgery
Subfield: Surgery
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $2,120
OpenAlex ID: W4410734047