Patient: female, 38 years old, weighing 60 kg, admitted to the hospital with periumbilical abdominal bulge after delivery of 3 children. On examination: the patient was of medium build, with a bulging abdomen in the standing position, a weak periumbilical abdominal wall evident, little subcutaneous fat, and loose skin. In the lying position, the abdomen was flat and soft without masses. Diagnosis: abdominal wall bulge (ventral white line hernia). Treatment: ventral wall hernia repair + abdominoplasty was performed. Result: good. Discussion: There are two possible causes of abdominal bulging in fertile women: accumulation of abdominal fat or laxity of the abdominal wall and, in severe cases, abdominal wall hernias. The choice of treatment is determined on a patient-by-patient basis. Liposuction is not advisable for patients with a flaccid and bulging abdominal wall; it is not only ineffective, but may even damage the abdominal wall. Abdominoplasty is a better solution to abdominal wall laxity.