Objective. To describe the original technique of myofascial correction of abdominal wall with combined plication of aponeurosis of rectus abdominis muscles.

Material and methods. We retrospectively analyzed 141 females who underwent abdominoplasty between 2019 and 2022. Mean age of patients was 37.2 years. We enrolled patients with minimum follow-up period of 6 months. All patients were divided into two groups: group 1 (n=31; 22%) — patients with severe diastasis Keramidas type C and D undergoing abdominoplasty with combined aponeurosis plication; group 2 (n=110; 78%) — patients with all types of diastasis who underwent abdominoplasty with classical vertical plication of aponeurosis of rectus abdominis muscles. Treatment outcomes were analyzed considering images of patients in 6 standard projections. We assessed residual rounding of the abdomen, postoperative complications and patient satisfaction with postoperative outcomes.

Results. There was no residual rounding of the abdomen in the 1st group. Seroma occurred in 6.4% of cases. There were higher postoperative outcomes (significant improvement in 94.2% of cases and improvement in 5.8% of cases) compared to the 2nd group. In the last group, postoperative seroma occurred in 4.5% of cases, hematoma — 2.3%, need for correction of postoperative scar — 6.3%, residual rounding of the abdomen — 6 patients. Patients rated postoperative results as significant improvement in 82.5% of cases and improvement in 17.5% of cases.

Conclusion. Additional plications reinforces musculoaponeurotic layer of anterior abdominal wall, creates a natural rete and prevents complications, in particular, residual rounding. Combined aponeurosis plication is optimal for patients with severe diastasis of rectus abdominis muscles.

Keywords. abdominoplasty, diastasis of rectus abdominis muscles, plication