A tummy tuck is designed to improve three different elements of the abdominal wall: the muscles (rectus diastasis), the fat beneath the skin, and the skin itself. In different people more or less may need to be done to each of these elements. In women who have had multiple pregnancies or large pregnancies, the muscle separation or rectus diastasis is key to getting a good shape. In order to gain access to the muscles, the incisions and dissection for the tummy tuck must be performed. So, there really in no way to repair the muscle separation short of a tummy tuck.
While performing the tummy tuck, I will use liposuction to thin out the layer of fat underneath the skin in women who need this. This involves a technique referred to as a lipoabdominoplasty which is a bit different from the traditional abdominoplasty or tummy tuck. However, having done both, I think the results of the lipoabdominoplasty are superior in terms of the overall shape of the abdomen.
The loose or excess skin will be removed in each of these techniques. In most women we like to be able to remove all the skin from the belly button down to the pubic region (full tummy tuck). In women who do not have much excess skin, less will be removed (mini-tummy tuck). In some of these women, the only real muscle separation is below the belly button, requiring less muscle repair.
But the muscle work is very important to the results of a tummy tuck, and there is really no way to repair the muscle separation without a tummy tuck.
