Introduction: Abdominal wall defects and muscle redundancy in the form of protruded abdomen still represent a challenging problem. The aim of this article is to reconstruct the abdominal wall and regain the abdominal contour through the application of biosynthetic meshes in certain fashion. Patients and Methods: this is a prospective study done 25 patients with long standing ventral hernia and lax abdominal muscle wall. All patients were performed at Zagazig university hospitals in the period between September 2011 and November 2013. Polypropylene mesh is used for every patient after anatomical hernia repair for hernioplasty and then shaping like outstretched hand (fingers processes). The aim is to reinforce the abdominal wall and reshape the abdomen. Results: regarding to the aesthetic aspect and success rate of the abdominal wall reconstruction, we have a good satisfactory results without recurrence in a period of 2 years follow up. Three patients are suffered from wound infection and partial edge ischemia in two patients. Bleeding and delayed wound healing in ten patients and persistent seroma are occurred in fife patients. Conclusion: It is safe with a good patient satisfaction to combine ventral hernia repair and abdominoplasty in cases with excess skin and musculofascial laxity of the abdominal wall (pendulous abdomen) with application of this finger processes mesh, after following the proper technique and precautions.
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