الفهرس 
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Abstract
A
bdominoplasty is considered by many general surgeons as only an aesthetic technique. It has shown to provide great benefits for patients: (1) removal of excessive skin, which promotes better local hygiene and reduces incidence of skin infections; (2) strengthening of muscular bending (better muscular tone, corporal position, and then de-ambulation); (3) stabilization of the lumbar spine level (by changing the angle of lumbar lordosis and sacral inclination, improving the chronic low back pain), scar removal and, finally, a better perception of their bodies (higher selfesteem, satisfaction and quality of life), less anxiety, and better personal relationships. All these changes are always desirable for all patients.
The repair of incisional hernias still represents a challenge for most of surgeons. It is a common procedure but lacks a specific systematic protocol on how this repair should be made. Repair of incisional hernia and abdominoplasty are 2 different operations: incisional hernia is a medical condition and abdominoplasty is an aesthetic surgery. However, they often have a common origin. In addition, large incisional hernias often coexist with rectus diastasis. Both result on marked stretching forces and high pressure on skin and abdominal tissue resulting in musculature weakening. It seems to make sense to aim for a comprehensive operation where the hernia repair could be associated to another procedure able to stabilize the abdominal wall and firm up the overlying tissue and skin as abdominoplasty is.
Preoperative risk factor modification and a useful diagnostic algorithm have a highly significant role in preparing a patient with incisional hernia for the right operation. New hernia repair techniques have the potential to continue to reduce the associated morbidity.
For a surgical team to offer a complete service for abdominal wall reconstruction for patients with incisional hernias, the following techniques should be mastered: prosthetic materials, abdominal components’ separation, tissue expansion, vacuum-assisted closure devices, local and distant muscle flaps, and free tissue transfer. This usually means that the abdominal surgeons must be working in partnership with plastic surgeons for achievement of the adequate reconstruction of the anterior abdominal walls in patients with incisional hernias.
In conclusion, abdominoplasty can be performed in combination with hernia repair in patients with incisional hernias, especially when associated with large sized defects or divercation of recti. Simultaneous techniques can be safely performed with the same morbidity and recurrences, but with major quality of life improvement and superiority over hernioplasty alone