Is Longer Better? Revisiting Compression Duration After Abdominoplasty with Diastasis Repair

This randomized controlled trial evaluated whether prolonged postoperative compression provides clinical benefit after abdominoplasty with rectus diastasis repair. One hundred twenty patients were randomized to wear a standardized class-II abdominal compression garment for 1, 3, or 5 months. Outcomes included inter-recti distance (IRD) stability, edema, venous-lymphatic function, intra-abdominal pressure (IAP), abdominal wall strength, return to activity, patient-reported outcomes, and complications. At 6 months, IRD stability in the 1-month group was non-inferior to the 3- and 5-month protocols, with mean IRD changes of + 1.2 mm, + 1.3 mm, and + 1.4 mm, respectively. Prolonged compression was associated with delayed edema resolution, reduced venous flow, and higher IAP at 1-3 months. Functional recovery was faster with shorter garment use; patients in the 1-month group demonstrated earlier return to activity and higher early trunk strength performance. Patient comfort was significantly better with shorter wear duration, while aesthetic satisfaction was similarly high in all groups by 12 months. Complication rates-including seroma and wound issues-were low and comparable among groups. Extended compression beyond the first postoperative month did not improve abdominal wall stability, contour, or patient satisfaction. Instead, it was associated with transient physiologic drawbacks and reduced comfort. A 1-month protocol followed by guided weaning provides optimal balance between mechanical support, recovery, and patient experience.Level of Evidence I This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .