Aesthetic Plastic Surgery

, Volume 35, Issue 4, pp 435–438 | Cite as

Analysis of the Strength of the Abdominal Fascia in Different Sutures Used in Abdominoplasties

  • Luis Henrique Ishida
  • Rolf Gemperli
  • Marco Vinicius Losso Longo
  • Helio Ricardo Nogueira Alves
  • Pedro Henrique Quintino da Silva
  • Luis Carlos Ishida
  • Marcus Castro Ferreira
Original Article



Protrusion of the abdominal wall secondary to abdominoplasty may occur in patients with weakness of the aponeurotic structures. The anterior layer of the rectus abdominis muscle consists of fibers that are transverse rather than vertical. Based on this anatomical feature, vertical sutures are suggested for the correction of diastasis recti, since they include a greater amount of fascial fibers and thus would be more resistant to tensile strength than horizontal ones.


The anterior layers of the rectus abdominis muscles of 15 fresh cadavers were dissected. Two vertical lines were marked on each side of the linea alba, corresponding to the site where plication is usually performed in abdominoplasties. Three abdominal levels were evaluated: the supraumbilical, umbilical, and infraumbilical levels. A simple suture was placed in the vertical direction in one group and in the horizontal direction in the other group, at each of the three levels previously described. These sutures were connected to a dynamometer, which was pulled medially toward the linea alba until rupture of the aponeurosis occurred.


The mean strength required to rupture the aponeurotic structures in which the vertical sutures had been placed was greater than for the horizontal ones (p < 0.0001).


The vertical suture of the rectus abdominis sheaths was stronger than the horizontal suture because of the more transversal arrangement of its aponeurotic fibers. Thus, routine use of the vertical suture in plications of the aponeurosis of the rectus abdominis muscles is suggested.


Abdominal wall Abdomen Rectus abdominis Surgical wound dehiscence 



The authors have no commercial interests or financial/material support in the present study to declare.


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Copyright information

© Springer Science+Business Media, LLC and International Society of Aesthetic Plastic Surgery 2011

Authors and Affiliations

  • Luis Henrique Ishida
    • 1
  • Rolf Gemperli
    • 2
  • Marco Vinicius Losso Longo
    • 1
  • Helio Ricardo Nogueira Alves
    • 1
  • Pedro Henrique Quintino da Silva
    • 3
  • Luis Carlos Ishida
    • 1
  • Marcus Castro Ferreira
    • 4
  1. 1.Hospital das ClinicasUniversity of São Paulo School of MedicineSão PauloBrazil
  2. 2.Plastic Surgery DepartmentUniversity of São Paulo School of MedicineSão PauloBrazil
  3. 3.University of São Paulo School of MedicineSão PauloBrazil
  4. 4.Plastic Surgery DepartmentUniversity of São Paulo School of MedicineSão PauloBrazil

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