The Management of Mild Skin Laxity in Post-Gravidic Diastasis Recti: A Retrospective Cohort Study Comparing...

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.

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