Abdominoplasty: Both vertical and horizontal plication required or is vertical plication enough for an extremely active person?

Question

Photos not supplied. Advice only. 44 years old female/Weight 60kg/height 172 cm/normal weight. Extremely active – involved in surfing & SUP surfing (challenging core) and lift heavy weights. Have Been recommended 2 types of procedure: 1) Abdominoplasty - vertical plication only 2) Abdominoplasty - horizontal and vertical plication. Which is the preference? Will vertical plication only suffice for my heavy sport involvement? Or should I go for vertical and horizontal due to my extreme sports

Amir Sadr, MD, MSc (Plast), FEBOPRAS · Answer

Dear Weddingplanner1234
Thanks for sharing your question. Usually for majority of women who only had changes associated with pregnancy , usually the vertical midline placating is enough. Some women who have lost some of their muscle tightness, they can have -location in other directions usually oblique or L shaped which can further tighten the muscles or make the waist line more defined.I usually ask about patients preferences but final decision would be made during operation when I tighten the midline and assess the laxity of abdominal wall. You will need a clinical examination to determine the level of muscle laxity.I hope you find this answer useful.

J. Timothy Katzen, MD, FACS · Answer

Thank you for your question regarding if vertical and horizontal plication is necessary during your abdominoplasty. I usually perform vertical plication and my patients that snatches their waistline by 2-6 inches alone. Especially if you are healthy and heavily involved in sports, I think a vertical plication will suffice.

Thank you for your question regarding if an abdominoplasty with vertical plication is enough for an extremely active person/

Lisa Sacks, MBBCh, FRCS · Answer

Dear Weddingplanner1234,From the description of your body, I would not recommend anything other than a vertical muscle plication. You don't say whether you have had multiple pregnancies, nor massive weight loss.The vertical plication repairs the split in the muscles caused by pregnancy or excessive intra abdominal fat (that has been lost). It is simply repairing or reconstructing the muscle to correct the defect. There is no defect in the horizontal plane that needs correcting. In my 27 years of experience I have not found the need to do a horizontal plication in a patient requiring an abdominoplasty, including any of my patients, some of who are super fit athletes.I hope this information is helpful.

Ahmad H. Ahmadi, MD · Answer

The use of vertical plication or vertical and horizontal plication really depends on the degree of laxity of the abdominal wall, not as a preventive measure for expected intense activity.  Some may advocate the use of mesh, which most board-certified plastic surgeons would consider excessive even if absorbable mesh is used.

Jeremy S. Hurren, BSc, MBBS, FRCS (Plast) · Answer

Firstly it is not possible to give you specific advice without examining you. I advise you to have a consultation with a suitably qualified and experienced plastic surgeon. If a surgeon has advised vertical and horizontal plication there may be a good reasons for this. I assume you are referring to plication of the rectus sheath for diastasis or divarication. Divarication usually only requires a vertical plication which is what I would consider to the the standard or routine practice. Some people with a good muscle core do not need any plication of the rectus sheath and there are certainly patients on whom I would not plicate the recuts sheath. If you are already practicing 'heavy sports' it possible that you do not need a plication! or at least it would make very little difference. Sorry to give you a third option to consider!Best wishes.

Abdominoplasty: Both vertical and horizontal plication required or is vertical plication enough for an extremely active person?

Answers (7)

Answer: Plication depends on abdominal wall laxity

Answer: Plication depends on abdominal wall laxity

Answer: Horizontal and or vertical plication for abdominoplasty

Answer: Horizontal and or vertical plication for abdominoplasty

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Abdominoplasty: Both vertical and horizontal plication required or is vertical plication enough for an extremely active person?

Answers (7)

Answer: Plication depends on abdominal wall laxity

Answer: Plication depends on abdominal wall laxity

Answer: Horizontal and or vertical plication for abdominoplasty

Answer: Horizontal and or vertical plication for abdominoplasty

Browse related questions

Recommended reading

Everything you need to know about Tummy Tuck

Our mission is to create a world where every investment in modern beauty is Worth It.