Intramuscular Pressure Dynamics During Rectus Abdominis Fat Grafting and Plication

Area of Science:

• Plastic Surgery
• Aesthetic Medicine
• Surgical Physiology

Background:

• Rectus abdominis fat transfer (RAFT) is popular for abdominal contouring.
• The impact of RAFT and abdominal plication on intramuscular pressure is not well understood.
• Standardized fat grafting volumes were used to investigate pressure changes.

Purpose of the Study:

• To characterize intramuscular pressure changes during RAFT.
• To differentiate the effects of fat grafting versus abdominal plication on muscle pressure.
• To assess immediate outcomes and complications associated with pressure changes.

Main Methods:

• Retrospective cohort study of 86 patients undergoing RAFT.
• Intraoperative intramuscular pressure monitoring at three time points: pre-grafting, post-grafting, and post-plication.
• Measurements in rectus abdominis and external oblique muscles using standardized fat grafting volumes.

Main Results:

• Fat grafting alone caused minimal pressure changes.
• Abdominal plication significantly increased intramuscular pressure in multiple regions, including external obliques.
• No fat necrosis or ischemia observed; complication rate was 3.48% (surgical site infections).
• High patient satisfaction reported post-procedure.

Conclusions:

• Abdominal plication is the main driver of increased intramuscular pressure in RAFT.
• Fat grafting has a limited effect on intramuscular pressure.
• Increased pressure did not lead to immediate adverse events, but optimal thresholds require further study.