Morphological Changes in Rectus Abdominis Muscle Associated With Pregnancy and Abdominoplasty

Abstract Background Pregnancy can alter the rectus abdominis, but abdominoplasty can potentially correct these changes. Objectives The aim of this study was to examine these muscle changes during pregnancy and to evaluate how effectively abdominoplasty with double folds of the rectus abdominis tightens the muscle. Methods Clinical data were obtained from nulliparous and pregnant patients who had undergone abdominoplasty with double folds of the rectus abdominis. Measurements were made of linea alba width, rectus abdominis width, thickness, and cross-sectional area, and abdominal circumference. Postoperative complications were also recorded. Patient satisfaction with the morphology of the rectus abdominis, both pre- and postsurgery, was assessed on a 5-point Likert scale. Results The study included 400 women: 171 nulliparous, 106 with 1 pregnancy (Group 1), and 123 with 2 or more pregnancies (Group 2). Complete postoperative data were available for 32 patients (Group 3). Significant widening of the linea alba was found in Groups 1 and 2. The rectus abdominis width increased significantly in Group 1 but not in Group 2. Its thickness remained unchanged in Group 1 but decreased in Group 2, mirroring the pattern of its cross-sectional area. In Group 3, both the linea alba and rectus abdominis width decreased, while thickness and cross-sectional area increased. Satisfaction with muscle morphology improved significantly postsurgery, with no serious complications reported. Conclusions Pregnancy can cause the rectus abdominis muscle to separate, widening the linea alba and flattening the muscle. Abdominoplasty, which reinforces the muscle with double folds, effectively resolves this, resulting in high patient satisfaction and few complications. Level of Evidence: 3