Pilot Study: Abdominoplasty Combining Median Rectus Plication and External Oblique Muscle Advancement: The Internal Corset Technique

Background: Abdominal contour deformities frequently result from skin laxity, localized adiposity, and multidirectional musculoaponeurotic laxity. Although median rectus plication effectively corrects diastasis, residual abdominal bulging and limited waist definition may persist. This study presents a technique combining median rectus plication with medial advancement of the external oblique muscles. Methods: A prospective observational case series was performed, including 22 female patients (body mass index < 28 kg/m 2 ) undergoing abdominoplasty with median rectus plication and external oblique muscle advancement combined with liposuction. The primary endpoint was reduction in abdominal circumference at the umbilical level at 3 months. Measurements were obtained with the patient relaxed and standing. Paired t test analysis was performed after verification of normality using the Shapiro–Wilk test. Results: Abdominal circumference decreased from 85.7 ± 7.7 cm preoperatively to 75.4 ± 6.4 cm at 3 months, corresponding to a mean reduction of 10.3 ± 3.5 cm (95% confidence interval, 8.8–11.9 cm; P < 0.001). Mean follow-up was 12 months (maximum 24 mo). No cases of late lateral bulging or thromboembolic events were observed in this limited sample. Conclusions: The combination of median rectus plication and external oblique muscle advancement demonstrated a significant reduction in abdominal circumference in this observational case series, suggesting that this approach may represent a valuable technical adjunct in contemporary abdominoplasty.