Clinical & Radiological Study of the Abdominal Wall Repair after Abdominoplasty

Background: Abdominoplasty is a widely performed procedure for correcting abdominal contour deformities, particularly those associated with rectus diastasis. Despite the availability of multiple plication and reinforcement techniques, recurrence remains a concern, especially in patients with significant musculoaponeurotic laxity. Aim: To clinically and radiologically evaluate the long-term durability of abdominal wall repair after abdominoplasty using mesh versus conventional plication alone. Materials and Methods: Twenty-five female patients who underwent abdominoplasty for pendulous abdomen with fascial laxity were allocated to Mesh (n = 12) or No-Mesh (n = 13) groups (mean age 41.1 ± 8.8 years, BMI 30.7 ± 3.6 kg/m²). Inter-recti distance was measured on axial multidetector CT at standardized levels preoperatively and at 3, 6, and 12 months. Operative time, intraoperative blood loss, early complications, time to return to normal activity, and patient-reported scar and contour satisfaction were prospectively recorded. Results: Mean operative time was 150.5 ± 24.6 minutes and mean blood loss 333.5 ± 82.6 mL. Early complication rates were low: seroma 8%, hematoma 4%, surgical site infection 4% and wound dehiscence 4%. Mean scar and contour satisfaction scores were 8.33 ± 0.90 and 8.68 ± 0.80, respectively, and mean time to return to normal activity was 21.2 ± 4.1 days. Baseline upper and lower IRD values did not differ between groups. The Mesh cohort demonstrated greater and sustained IRD reduction: upper IRD at 12 months 2.02 ± 0.04 cm versus 2.36 ± 0.16 cm in the No-Mesh cohort (p < 0.001); lower IRD at 12 months 1.95 ± 0.05 cm versus 2.18 ± 0.14 cm (p < 0.001). Conclusion: Both techniques are safe and enjoy high patient satisfaction. However, mesh reinforcement clearly results in better and more durable CT-confirmed anatomical correction of the rectus diastasis. Selective use of mesh in cases with severe separation or poor tissue quality is recommended to minimize the risk of recurrence.