The Suprapubic Dermoadipose Flap for Aesthetic Reshaping of the Postpregnancy Abdomen

Aesthet Surg J. 2018 May 15;38(6):635-643. doi: 10.1093/asj/sjx175.


Background: Postpregnancy full-length diastasis of the recti abdominis muscles is a common condition occasionally associated with atrophy of the subcutaneous fat located at the midline above and below the umbilicus.

Objectives: The authors report a preliminary clinical experience with the suprapubic flap to prevent the late postoperative contour deformities of the postpregnancy abdomen.

Methods: Between January 2005 and January 2015, all female patients undergoing abdominoplasty with the suprapubic flap were included in the present study. Electronic clinical records were reviewed to analyze the patients' ages, body mass index (BMI) scores, pregnancies, risk factors, and operative times, followed by a telephone-based survey to measure patient satisfaction.

Results: Twenty-two patients were included. Their ages ranged from 19 to 36 years (mean, 27 years) and their BMI ranged from 17.5 to 22.5 kg/m2 (mean, 20.5 kg/m2). Postoperative follow up ranged from 12 months to 10 years (mean, 89 months). All patients had experienced at least one pregnancy and many of them multiple or twin pregnancies. Umbilical hernias were present in 18 patients. There were 5 unusual cases: one hematoma, one seroma, and three cases of hypertrophic scarring. Thirteen additional minutes were required, on average, to associate the flap. All patients were satisfied or very satisfied with the results.

Conclusions: The suprapubic dermoadipose flap is an effective option to prevent the midline depression that would otherwise remain on the hypogastric region of postpregnant slim women with midline fat tissue atrophy.

MeSH terms

  • Abdominal Wall / surgery*
  • Abdominoplasty / methods*
  • Adult
  • Atrophy / etiology
  • Atrophy / pathology
  • Body Mass Index
  • Diastasis, Muscle / etiology
  • Diastasis, Muscle / surgery*
  • Esthetics
  • Female
  • Humans
  • Patient Satisfaction
  • Postpartum Period
  • Rectus Abdominis / pathology*
  • Rectus Abdominis / surgery
  • Subcutaneous Fat / pathology
  • Surgical Flaps / transplantation*
  • Treatment Outcome
  • Young Adult