[Postpartum pleated abdomen. Clinical individualization. Surgical possibilities]

Post-partum pleated abdomen is a polymorphic combination of skin and abdominal wall lesions which warrants an illustrated classification. It is observed in small women who have delivered large babies or twins. Various anatomo-clinical forms can be distinguished, ranging from the slightly flaccid stretched abdomen to the severely and globally pleated abdomen, involving the suprapubic region as far as the epigastrium or only consisting of segmental abdominal pleats. The operative indication should be very cautiously considered especially when the abdominal pleats are not already associated with scars. There is now a wide variety of techniques ranging from simple suprapubic modelled cutaneous resection with possible translocation of the umbilicus to bi-axial cutaneous resection which is occasionally the only logical solution for severe cases of pleated excess skin.