The Management of Mild Skin Laxity in Post-Gravidic Diastasis Recti: A Retrospective Cohort Study Comparing Mini-Inverted-T and Mini-Abdominoplasty With BODY-Q.

UNLABELLED:

Introduction

Post-gravidic diastasis recti is corrected with conventional abdominoplasty in patients with adequate skin laxity. For unsuitable patients, other procedures are considered.

Methods

A retrospective review was conducted on patients undergoing mini-abdominoplasty or mini-inverted-T abdominoplasty from 2019 to 2023 at our institution, excluding overweight and post-bariatric patients. Patient-reported outcomes were evaluated using the BODY-Q questionnaire, administered one year postoperatively. Two plastic surgeons assessed pre and postoperative photographs, rating cosmetic outcomes on a Likert scale. Complication rates were also compared.

Results

A total of 64 patients had mini-abdominoplasty and 73 underwent mini-inverted-T abdominoplasty. The groups were similar in age, pregnancies, and smoking habit (P > .05). The mini-abdominoplasty group had a lower mean BMI (20.81 ± 1.69 vs 21.44 ± 1.58 kg/m2; P = .028) and narrower mean diastasis (4.65 ± 1.10 vs 5.08 ± 1.19 cm; P = .031). Mini-abdominoplasty patients reported lower satisfaction with abdomen (59.47 ± 33.82 vs 69.82 ± 25.48; P = .158) and skin excess (74.13 ± 28.50 vs 83.23 ± 25.04; P = .157), but better outcomes in body contouring scars (73.25 ± 27.61 vs 64.56 ± 32.17; P = .232). Multivariate analysis confirmed higher score satisfaction with abdomen scale in the mini-inverted-T group (P < .028). Surgeons rated scar quality (6.94 ± 1.17 vs 5.51 ± 1.25, P < .001) and symmetry (6.44 ± 1.17 vs 5.42 ± 1.36, P < .001) higher for the mini-abdominoplasty group, while profile (6.72 ± 1.20 vs 8.23 ± 1.17, P < .001) and overall appearance (6.53 ± 1.07 vs 7.66 ± 1.07, P < .001) were rated higher for the mini-inverted-T group. Complications and revision rate did not differ statistically between the groups.

Conclusions

Both procedures are viable options for selected patients with advantages and limitations that should be discussed to align with patients' characteristics and expectations. Mini-inverted-T scar abdominoplasty is recommended unless the patient is more concerned about scars rather than the overall abdominal shape and profile.

LEVEL OF EVIDENCE: III.