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. 2025;2(2):695.
Epub 2025 Aug 9.

Post-Caesarean and Post-Laparotomy Abdominal Wall Reconstruction (Tummy Tuck) For Aesthetic and Functional Restoration in A Low Resource Setting: A Case Report

Chinedu Nnaemeka Ilokanuno  1   2 , George Uchenna Eleje  3   4 , Chimaobi Markson Isiguzo  5 , Chichi Ukoha  6 , Ekeuda Uchenna Nwankwo  7 , Emmanuel Chukwubuikem Egwuatu  4 , Kenechukwu Ezekwesili Obi  4 , Chukwuemeka Chukwubuikem Okoro  4 , Chukwudubem Chinagorom Onyejiaka  4 , Chiemezie Mac Kingsley Agbanu  4 , Michel Chiedu Egbuniwe  8 , Adanna Vivian Egwim  4 , Johnbosco Emmanuel Mamah  9 , Obinna Kenneth Nnabuchi  4 , Chigozie Geoffrey Okafor  2 , Stanley Chigaemezu Egbogu  4 , Onyecherelam Monday Ogelle  4 , Emmanuel Onyebuchi Ugwu  10 , Gerald Okanandu Udigwe  1   2 , Blessing Ifunanya Enyi  11 , Uchenna Clara Chijioke Ofoma  12 , Chidinma Theresa Ezidiegwu  13 , Ahizechukwu Chigoziem Eke  14
Affiliations

Post-Caesarean and Post-Laparotomy Abdominal Wall Reconstruction (Tummy Tuck) For Aesthetic and Functional Restoration in A Low Resource Setting: A Case Report

Chinedu Nnaemeka Ilokanuno et al. CME J Clin Case Rep. 2025.

Abstract

Background: Complex abdominal wall reconstruction following multiple surgical interventions remains challenging in resource-limited settings. We report the first successful case of combined post-caesarean and post-laparotomy total abdominal wall reconstruction with mesh reinforcement in a low-to-middle-income country setting.

Case presentation: A 27-year-old multipara Nigerian woman presented with severe abdominal wall laxity and aesthetic deformity following caesarean delivery complicated by cryptogenic ascites requiring exploratory laparotomy. Clinical examination revealed extensive abdominal wall weakness with positive diastasis recti (Diver's test). She underwent comprehensive abdominal wall reconstruction, including total abdominoplasty with polypropylene mesh reinforcement. Intraoperative findings demonstrated diffuse muscle attenuation without discrete hernial defects. The procedure was completed without complications, with 0.8kg of excess tissue excised. The patient achieved complete wound healing by postoperative day 15 with excellent functional and aesthetic outcomes maintained at 15-month follow-up. No postoperative complications, mesh-related adverse events, or recurrence of abdominal wall laxity were observed.

Conclusion: This case demonstrates the feasibility and safety of complex abdominal wall reconstruction in resource-constrained environments when appropriate patient selection, surgical technique, and perioperative management are employed. The successful outcome challenges conventional assumptions about the technical requirements for such procedures and supports the expansion of reconstructive surgical services in low-resource settings.

Keywords: Abdominoplasty; Exploratory Laparotomy; Mesh Repair; Sagging Abdomen; Satisfactory Healing.

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Conflict of interest statement

Disclosure The authors declare that there is no conflict of interest in this work.

Figures

Figure 1:
Figure 1:
The Abdominal Wall Before the Surgical Procedure
Figure 2:
Figure 2:
The Flattening of Abdominal Wall Before the Procedure
Figure 3:
Figure 3:
Abdominal Flap Raised
Figure 4:
Figure 4:
On-Lay Mesh Done
Figure 5:
Figure 5:
Tailoring and Excision
Figure 6:
Figure 6:
Immediate Post-Op
Figure 7:
Figure 7:
5th Day Post-Operation
Figure 8:
Figure 8:
10th Day Post-Operation
Figure 9:
Figure 9:
15th Day Post-Operation with Neo Umbilicus Healed
Figure 10:
Figure 10:
15th Day Post-Operation Side View with Protective Dressing
See this image and copyright information in PMC

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