I have seen the term "Excessive Plication" as something that should be done to remedy an unsuccessful TT where the upper abdomen still protrudes excessively. Please explain what this means--is additional fascia removed? Is the plication more extreme? Any information would be very appreciated.
What is "Excessive Plication" in Reference to an Abdominoplasty?
Doctor Answers 8
Plication VS. Excessive Plication in Abdominal Wall Tightening of Tummy Tuck Procedures
Plication of abdomen
I have never heard the term excessive plication. There may be excessive laxity or diastass that requires a plication.
Plication for Tummy Tuck
Plication is the term used to tighten the muscles (actually the fascia that surrounds the muscles) together during abdominoplasty. If you think of the abdomen as two sections - one section above the belly button and one section below the bellybutton - it may help. If one section, say below the belly button, is tightened too much, then the area above the belly button my pouch out since there is a limited volume in the abdomen. I hope this helps answer your question. Good luck.
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"Excessive Plication" in Reference to an Abdominoplasty
After reading the other expert postings I'm in 100% agreement with Dr Placik's statements concerning this issue of "excessive plication". You must be sure to fully understand this operation prior to having the operation. This is informed consent. From MIAMI Dr. Darryl J. Blinski, 305 598 0091
How tight is tight: "excessive plication" and muscle repair in tummy tuck
Excessive plication refers to additional tightening of the fascia between the two rectus muscles in order to treat a recurrent or undercorrected initial attempt. However, excessive plication can be excessive resulting in greater pulmonary resistance and decreased respiratoty compliance with diminished venous return.
Tummy tuck plication
Patients that have residual abdominal bulging after tummy tuck surgery in which plication was performed have one of two issues-
1. Either their fascial laxity was so severe that even good approximation of the recuts muscles failed to flatten their abdominal wall.
2. The fascial plication that was done was insufficient, or more worrisome, failed mechanically, resulting in recurrent abdominal bulging.
The terminology 'excessive plication' as a 'remedy' for abdominal wall laxity seems a little odd, frankly.
Terminology about muscle tightening with abdominoplasty
Since most patients who are good candidates for an abdominoplasty have had some separation of the rectus muscles - the ones that go from the ribs to the pubic area and form the "six pack" - pulling them together with sutures is routine. This is called plication. Once they are back to their normal position, without a separation between, there really isn't anywhere to position them with additional plication. If the plication didn't hold then a secondary procedure would be appropriate, but I haven't seen the term "excessive" applied to this as it implies doing something beyond what is necessary.
Plicarion during a tummy tuck needs to be done right
I'm not sure where you heard excessive plication. If the plication is done correctly the first time than there should be no upper abdominal fullness. If further plication is needed it's because it was insufficient originally and is now being fixed, but it is not "excessive".