How to Re-correct Muscle Seperation After Full Tummy Tuck?

I am 2.5 months post full TT. I just went to the walk in clinic today and the doc said I have a little bit of abdominal muscle seperation above my BB, which is where the bulge is. My question is, do I have to get the whole incision line cut open again and flap lifted or can this be done endoscopically. No fat and no skin needs to be removed. Just muscles need to be re-tightened in this area only. Are there any docs in Vancouver, BC or even Seattle that does this (endoscopically). Pls Hlp!!

Doctor Answers (5)

Fullness above belly button can be caused by several factors

+1

Hello,

Thank you for the question.  There are several possibilities for perceived fullness above your belly button. Fat excess, seroma, pseudobursa, unequal tightening of the abdominal wall, and finally abdominal wall tightening separation are all options.    I would discuss this with your plastic surgeon as he/she will be the best to diagnose you as well as offer you options for correction.  If you do have abdominal wall weakening an endoscopic muscle tightening is an option.

All the best,

Dr Remus Repta


Scottsdale Plastic Surgeon
5.0 out of 5 stars 92 reviews

Tummy tuck complication

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I am a little confused about your situation- why would you be allowing “walk in clinic doc" to make a diagnosis in your situation 2.5 months after abdominoplasty?

In my opinion, without a accurate/reliable diagnosis discussing treatment options is wasting your time. It would behoove you to follow-up with your plastic surgeon who knows your situation/anatomy far better than any other walk-in doc  or online consultant.

Best wishes.

Tom J. Pousti, MD, FACS
San Diego Plastic Surgeon
5.0 out of 5 stars 724 reviews

Re-do abodominoplasty

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How much surgery you will need really depends on how large the area of weakness is and why it occurred.  If it is a matter of just one or two plication sutures popping during a postoperative coughing fit, it may be possible to use the umbilical incision to access the weak area and put in some additional sutures.  If, however, a lot of sutures broke or pulled out, your surgeon will need better access.  It may be that this could be done with a scope or even a lighted retractor or your surgeon may need full access to the area through the original incision.  You need to go back to the surgeon who did your surgery and get his/her opinion.  If you are not comfortable with the answer, get a second opinion for a board certified plastic surgeon. 

I sure hope my patients don't go to a walk in clinic with questions about their surgery!

Lisa Lynn Sowder, M.D.

Lisa L. Sowder, MD
Seattle Plastic Surgeon
5.0 out of 5 stars 41 reviews

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Can a Muscle Seperation AFTER a Full Tummy Tuck be corrected?

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I agree with Dr. Rand. The first step in every military mission or in surgery is a debriefing. All information is collected and analyze to learn what we could have done better.

Muscle separation less than 3 months after surgery implies that either your stitches broke, cut through the tissues, the stitches were weak or poorly placed or that you put inordinate pull on the muscle (recurrent coughing, vomiting, blow to the stomach or doing abdominal exercises).

Endoscopic tummy tucks are rarely done and usually require a larger opening than just that of the belly button. Depending on HOW your muscles were brought together: one layer VS. two layers of stitches and continuous running VS. interrupted, multiple stitches may determine how the repair is done. In general, a single, continuous running stitch or using only a single layer of a few stitches are more apt to fail than using two layers of stitches. If the separation is limited to a small area just above or below the belly button it MAY be repaired like an umbilical hernia through the belly button opening. Opening of the bottom incision and the belly button incision may be required in larger defects.

Dr. Peter A Aldea

Peter A. Aldea, MD
Memphis Plastic Surgeon
5.0 out of 5 stars 60 reviews

Re-do tummy tuck

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This is not as easy as it might sound to you and in my opinion, you would need to reopen the entire surgery to retighten the muscles.  The most important question before considering any of that is "why did this happen?" Unless there is a correctable reason, it may well happen again and the process wouldn't be worth it.  Ask your doctor for some ideas about the "why" part.  Were you too active, tissues too thin, gained weight, inexperienced surgeon, etc

Richard P. Rand, MD, FACS
Seattle Plastic Surgeon
5.0 out of 5 stars 48 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.