Prospective One-Year Evaluation of the Safety and Effectiveness of an Investigator-Developed Rectus Abdominis Plication Technique in Abdominoplasty

Adults undergoing primary abdominoplasty with rectus diastasis will receive a standardized plication described in a locked operative manual. Baseline and postoperative ultrasound will measure the inter-rectus distance at three fixed abdominal levels. Operative variables and protocol adherence will be recorded. Follow-up visits through month 12 will assess anatomical durability, recurrence, abdominal wall function, patient-reported satisfaction, and complications. The study is designed to generate reproducible one-year safety and effectiveness estimates and to identify factors associated with recurrence.

Inclusion criteria

• Age 18 to 65 years.
• Scheduled for primary abdominoplasty with rectus plication.
• Rectus diastasis documented clinically or by baseline ultrasound.
• Stable body weight for at least 3 months before surgery.
• Ability to complete ultrasound and clinical follow-up through 12 months.
• Written informed consent.

Exclusion criteria

• Prior major abdominal wall reconstruction or mesh repair that prevents standardized plication assessment.
• Ventral or incisional hernia requiring a separate reconstructive procedure.
• Pregnancy, breastfeeding, or planned pregnancy during the 12-month follow-up.
• Uncontrolled systemic disease or contraindication to elective abdominoplasty.
• BMI greater than 35 kg/m2 unless the final operative protocol intentionally includes this population.
• Inability to obtain technically adequate baseline ultrasound measurements.