Figure 2 Surgical procedure: Release of scar tissue, abdominal wall defect repair, and transposition flaps for abdominal scar reconstruction. (A) Preoperative demonstration of the 8×2 cm scar under general anesthesia. (B) Complete excision of the scarred epidermis, creating an 8 cm defect. (C) Elevation of the superficial adipose layer (Camper’s fascia) exposing the underlying Scarpa fascia. (D) Intraoperative view after complete lateral scar release showing the exposed anterior rectus sheath. (E) Medial dissection along the scar margin reaching the Scarpa fascia plane. (F) Meticulous circumferential release of fibrotic adhesions around scar tissue. (G) Reinforcement of the abdominal wall by suturing the medial and lateral scar margins to the corresponding edges of the rectus sheath. (H) First-layer reconstruction using medially-based adipofascial flap (Scarpa’s fascia) sutured over the repaired defect. (I) Second-layer reconstruction with laterally-based adipofascial flap overlapping the medial flap. (J) W-plasty suture performed for incision closure and tension reduction.