Alternative Abdominal Wall Plication Techniques: A Review of Current Literature.

Abdominoplasty is one of the most common procedures performed in plastic surgery. Through the removal of redundant skin and fat tissue, body contouring is performed to narrow the waist and achieve a naturally flattened appearance. To achieve this, a technique frequently utilized during this procedure is the plication of the abdominal rectus sheath. While abdominal wall plication is a commonly utilized procedure performed during abdominoplasty, there is a lack of consensus regarding which plication method provides the greatest outcomes. Each variation addresses some of the common intraoperative and postoperative complications of abdominoplasty. These include extended operating time, rupture of the plication, epigastric bulging, and patient postoperative dissatisfaction. Many plication techniques have been described in the literature, but not a single technique has been adopted amongst plastic surgeons as the gold standard. Here we present a narrative comparison of current published literature reporting novel or modified abdominoplasty plication techniques. This includes diagrams of each procedure, sutures utilized, and key concepts of each plication technique. Discussion regarding how these modifications change operating time, alter epigastric bulging, and improve the ability to narrow the waist is provided. The purpose of this paper is to provide a concise source document for plastic surgeons to reference when choosing a plication method to use during abdominoplasty.