Treatment of umbilical hernia and recti muscles diastasis without a periumbilical incision.

[PURPOSE] Postpartum rectus diastasis eventually combined with umbilical hernia is a condition that is frequently treated by plastic surgeons and general surgeons. Standard treatment of this condition is abdominoplasty with a periumbilical incision, which often results in an umbilical incision or an inverted-T scar. Limited incision abdominoplasty differs from traditional abdominoplasty by disconnecting the umbilical stalk from the abdominal wall during flap dissection, thus allowing the resection of excess skin above and under the umbilicus without causing periumbilical scarring.

[METHODS] We conducted a retrospective cohort study of women undergoing a limited scar abdominoplasty without a periumbilical incision for the treatment of a separation of the recti muscles and/or an umbilical hernia. We recorded the postoperative complications and patient satisfaction with the results of the treatment.

[RESULTS] We operated on 50 patients from 2002 to 2010. We followed the patients for 2-8 years. The most common complication, as with other abdominoplasty procedures, was minor dehiscention in the middle part of the wound, which occurred in 16 % (n = 8) of the patients. All of these complications were treated conservatively. No recurrence of diastasis or umbilical hernia was observed.

[CONCLUSIONS] Extended miniabdominoplasty with a low suprapubic incision and umbilical caudalization for treating the diastasis of the abdominal rectus muscles and/or an umbilical hernia is an excellent method that results in a small, hidden scar. This method is especially beneficial for young, slim women with an abdominal wall deformity after pregnancy.