Morelli Coppola Marco, Petrucci Valeria, Grosu Felicia Geanina, Toto Vito, Tenna Stefania, Brunetti Beniamino, Persichetti Paolo
Operative Research Unit of Plastic, Reconstructive and Aesthetic Surgery, Fondazione Policlinico Universitario Campus Bio-Medico, Rome, Italy.
Research Unit of Plastic, Reconstructive and Aesthetic Surgery, Department of Medicine and Surgery, Università Campus Bio-Medico di Roma, Rome, Italy.
Plast Surg (Oakv). 2025 Jun 30:22925503251350892. doi: 10.1177/22925503251350892.
Post-gravidic diastasis recti is corrected with conventional abdominoplasty in patients with adequate skin laxity. For unsuitable patients, other procedures are considered.
A retrospective review was conducted on patients undergoing mini-abdominoplasty or mini-inverted-T abdominoplasty from 2019 to 2023 at our institution, excluding overweight and post-bariatric patients. Patient-reported outcomes were evaluated using the BODY-Q questionnaire, administered one year postoperatively. Two plastic surgeons assessed pre and postoperative photographs, rating cosmetic outcomes on a Likert scale. Complication rates were also compared.
A total of 64 patients had mini-abdominoplasty and 73 underwent mini-inverted-T abdominoplasty. The groups were similar in age, pregnancies, and smoking habit ( > .05). The mini-abdominoplasty group had a lower mean BMI (20.81 ± 1.69 vs 21.44 ± 1.58 kg/m; = .028) and narrower mean diastasis (4.65 ± 1.10 vs 5.08 ± 1.19 cm; = .031). Mini-abdominoplasty patients reported lower satisfaction with abdomen (59.47 ± 33.82 vs 69.82 ± 25.48; = .158) and skin excess (74.13 ± 28.50 vs 83.23 ± 25.04; = .157), but better outcomes in body contouring scars (73.25 ± 27.61 vs 64.56 ± 32.17; = .232). Multivariate analysis confirmed higher score satisfaction with abdomen scale in the mini-inverted-T group ( < .028). Surgeons rated scar quality (6.94 ± 1.17 vs 5.51 ± 1.25, < .001) and symmetry (6.44 ± 1.17 vs 5.42 ± 1.36, < .001) higher for the mini-abdominoplasty group, while profile (6.72 ± 1.20 vs 8.23 ± 1.17, < .001) and overall appearance (6.53 ± 1.07 vs 7.66 ± 1.07, < .001) were rated higher for the mini-inverted-T group. Complications and revision rate did not differ statistically between the groups.
Both procedures are viable options for selected patients with advantages and limitations that should be discussed to align with patients' characteristics and expectations. Mini-inverted-T scar abdominoplasty is recommended unless the patient is more concerned about scars rather than the overall abdominal shape and profile.
III.
对于皮肤松弛度足够的产后腹直肌分离患者，可采用传统腹壁成形术进行矫正。对于不适合的患者，则考虑其他手术方法。
对2019年至2023年在我院接受迷你腹壁成形术或迷你倒T形腹壁成形术的患者进行回顾性研究，排除超重和减肥术后患者。术后一年使用BODY-Q问卷评估患者报告的结局。两名整形外科医生评估术前和术后照片，采用李克特量表对美容效果进行评分。同时比较并发症发生率。
共有64例患者接受了迷你腹壁成形术，73例接受了迷你倒T形腹壁成形术。两组在年龄、妊娠次数和吸烟习惯方面相似（P>0.05）。迷你腹壁成形术组的平均体重指数较低（20.81±1.69 vs 21.44±1.58 kg/m²；P=0.028），平均腹直肌分离宽度较窄（4.65±1.10 vs 5.08±1.19 cm；P=0.031）。迷你腹壁成形术患者对腹部（59.47±33.82 vs 69.82±25.48；P=0.158）和皮肤多余度（74.13±28.50 vs 83.23±25.04；P=0.157）的满意度较低，但在身体轮廓疤痕方面效果较好（73.25±27.61 vs 64.56±32.17；P=0.232）。多因素分析证实迷你倒T形组在腹部量表上的满意度得分更高（P<0.028）。外科医生对迷你腹壁成形术组的疤痕质量（6.94±1.17 vs 5.51±1.25，P<0.001）和对称性（6.44±1.17 vs 5.42±1.36，P<0.001）评分更高，而迷你倒T形组在侧面轮廓（6.72±1.20 vs 8.23±1.17，P<0.001）和整体外观（6.53±1.07 vs 7.66±1.07，P<0.001）方面评分更高。两组之间的并发症和修复率在统计学上没有差异。
对于选定的患者，这两种手术都是可行的选择，各有优缺点，应与患者的特征和期望进行讨论。除非患者更关注疤痕而非整体腹部形状和轮廓，否则建议采用迷你倒T形疤痕腹壁成形术。
III级。
