This randomized trial aimed to assess the efficacy of preservation of Scarpa's fascia during hernio-abdominoplasty in reducing the volume of postoperative drainage, accelerating time to drain removal and recovery, and reducing complication rate.

Inclusion Criteria:

• Patients with complex ventral hernia that are fit for surgery (ASA class I and II) (Saklad, 1941).
• Patients with class III, IV according to Pitanguy's classification of abdominal deformities (Pitanguy, 1995).

Exclusion Criteria:

1. Patient with ASA class III, IV, and V.
2. Morbid obesity (BMI > 40).
3. Recurrent incisional hernias after mesh hernioplasty.
4. Strangulated hernias.
5. Isolated small paraumbilical hernias.
6. Patients with abdominal organomegaly and/or ascites.
7. Patients with coagulopathy,
8. Patients who are heavy smokers, patients with pulmonary problems, and patients with uncontrolled diabetes.