title: Abdominoplasty with Customized Transverse Musculoaponeurotic Plications.
abstract: BACKGROUND
  The standard abdominoplasty technique uses a wide, vertically oriented plication of the rectus sheath to narrow the waistline. However, this plication is not always enough to achieve good cosmetic and functional results. This is also the case with other plication techniques. To strengthen the abdominal wall at the points of greatest weakness in each particular patient, the authors have developed a personal technique consisting of customized transverse plications at the points of maximum protrusion in the musculoaponeurotic layer, in addition to the classic vertical plication.
  
  
  METHODS
  Ninety-eight women were divided randomly into two groups: the control group (group A) comprised 44 patients (44.9 percent) who underwent classic vertical plication; the experimental group (group B) comprised 54 patients (55.1 percent) in whom vertical plication was associated with one or more customized horizontal plications. Results were rated on a scale of 0 to 10 by external observers and the patients. Complications and recurrences were recorded.
  
  
  RESULTS
  In group A, the mean global rating scores were 8.5 of 10 for external raters and 8.3 of 10 for patients. In group B, they were 9.5 of 10 and 9.8 of 10, respectively. In group B, there were no recurrences of prominences, whereas three were recorded in group A. Five cases of seroma were registered in each group and resolved by closed suction.
  
  
  CONCLUSIONS
  In some cases, vertical plication with customized transverse plications produces results that are aesthetically superior to those of the classic approach, achieves long-lasting effects, and does not increase the rate of recurrences or the risk of complications.
authors.affiliation: Barcelona, Spain; and Naples, Italy From the International University of Catalonia; the Plastic Surgery Institute Dr. Serra-Renom, Hospital Quirón; and the Plastic and Reconstructive Surgery Department, Second University of Naples.
authors.forename: Jose-Maria
authors.initials: JM
authors.lastname: Serra-Renom
authors.forename: Lourdes
authors.initials: L
authors.lastname: Martinez-Teixido
authors.forename: Jose-Maria
authors.initials: JM
authors.lastname: Serra-Mestre
mesh_terms: D000009:Abdominal Muscles / Q000601:surgery*; D061645:Abdominoplasty / Q000379:methods*; D000328:Adult; D005260:Female; D006801:Humans; D008875:Middle Aged