Diastasis recti: Floppy Wall
Floppy Wall: what is it?
More correctly referred to asPFAD(postpartum floppy abdomen diastasis),
This is a severe form of abdominal rectus abdominis diastasis that is seen after childbirth, where even the superficial layers such as the panniculus adiposus and skin show signs of distress, hypotrophy, and sagging.
Significant weakening of the linea alba results in considerable IRD (Intra Recti Distance), or large distances between the two rectus muscles.
The muscles of the abdominal wall appear hypotonic, oblong, and thinned in their thickness.
What is it caused by?
The pathology is created slowly and progressively during the nine months of pregnancy, often due to the voluminous increases in volume in twin pregnancies or in cases of polydramnios (excessive formation of amniotic fluid). As for the diastases of minor entity, generally one does not notice the establishment of the pathology for the entire duration of pregnancy, but then at the time of delivery, the abdominal wall deters remaining atonic, leaving to show the severe rectus abdominis diastasis associated with the typical loss of thickness and muscle tone in addition to the conspicuous skin suffering.
How do you treat it?
Therapy should include both reconstruction of the severe rectus abdominis diastasis (which underlies this pathologic condition) and treatment of the superficial tissues.
In general, we prefer reconstructions via rectus muscles R-TAPP to achieve effective realignment of the rectus muscles.
The muscular realignment takes place in total respect of the anatomy by reconstructing the linea alba with a symmetrical and well balanced plication on the medial (central) margin of the rectus muscles.
In fact, it is common to witness the progressive improvement of results even several months or even years after reconstructive surgery, due to the natural recovery of muscle tone and trophism.
For the treatment of surface aspects such as large amounts of excess skin and irregularities of the panniculus adiposus, in the same operating session of the muscle-tendon reconstruction we usually combine extensive dermolipectomies, skin lifting, liposculpture and lipofillling to give tension to the skin and reshape the subcutaneous plane.