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These values could indicate the beneficial and synergic effect obtained with the combination of the 2 procedures compared with the results obtained with each technique separately.3,9,11,21 Thus, the PPP is more useful in the management of the 2 volumes (direct effect on the VIH/VAC ratio), while the effect of BTX lies in reducing the mainly transversal diameters of the defect, by achieving the temporary retraction of the lateral abdominal muscles.1 The hypothesis has also been proposed that the use of BTX complements the effect of PPP, as the flaccid paralysis of the lateral muscles accelerates the stretching of the abdominal wall
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