Evaluation of Adding Customized Plication in Lipoabdominoplasty: A preliminary Pilot Study in Zagazig University Hospitals

Background: Musculoaponeurotic laxity is a key contributor to abdominal wall deformities, particularly in postpartum women. While vertical (midline) plication remains the standard approach in abdominoplasty, it often falls short in achieving optimal waist definition and contour. This study evaluates the aesthetic and clinical outcomes of adding customized musculoaponeurotic plications such as transverse, oblique, or multidirectional to vertical plication in lipoabdominoplasty. So, we aimed to achieve better aesthetic body contouring Methods: This is a preliminary Pilot Study conducted at Zagazig University Hospitals and included 12 healthy multiparous female patients undergoing lipoabdominoplasty. Patients were divided based on plication technique: vertical-only (n=6), vertical + lateral (n=2), vertical + oblique (n=3), and crossbow (multidirectional) (n=1). Aesthetic outcomes were evaluated pre- and post-operatively using photographic documentation and waistline by tape measure and a five-point Likert scale assessing abdominal contour, waistline definition, and overall satisfaction. Complications, drain output, and recovery profiles were also analyzed. Results: The addition of oblique and multidirectional plications resulted in greater waist circumference reduction (p = 0.045) and higher patient satisfaction, despite not reaching statistical significance in satisfaction scores (early p = 0.786; late p = 0.643). No significant differences in complication rates or drain duration were observed among groups. Vertical-only plication showed a higher incidence of minor complications, such as dog ears and scar hypertrophy. All patients remained hemodynamically and metabolically stable throughout the perioperative period. Conclusion: Customized musculoaponeurotic plication techniques especially oblique and multidirectional approaches may offer superior aesthetic outcomes in lipoabdominoplasty without increasing complication rates or recovery time.