I have 2yr old twins and a 5yr old. When I went for consultation with one dr he talked about the muscle tightening he would do. But my hesitation now comes that I found an aquaitance of mine went in for a TT with the same dr. I asked a mutual friend if she was happy, she said that the only thing she was upset about was that he did not do muscle tightening with her TT. Her TT was needed due to gastric bypass weight loss. Is there a resitriction on doing the MR with gast.by?
Restriction on Muscle Repair with Tummy Tuck if Had Gastric Bypass?
Doctor Answers 4
Muscle Tightening is a MUST with ANY history of Andominal Distention (Pregnancies, Obesity etc)
The ONLY reason why a Plastic surgeon would NOT repair the split Tummy muscles would be if the patient had insurance pay for a Panniculectomy (resection of the overhanging apron) in which only the overhang is removed while the muscles are not brought together, the skin looseness above the belly button is not corrected and the belly button is not relocated. This procedure is NOT really a Tummy tuck (Abdominoplasty) but a lot of people mistake it for such.
In most people whose abdomens were distended and stretched out (Pregnancies, Obesity etc), the 6 pack (Rectus abdominis) muscles are permanently split and muscles are stretched out. If these muscles are not brought together and tightened, the operation will NOT yield the tightest tummy possible. There is NO reason why a muscle repair would NOT be done with Tummy Tuck such as Mommy Make-Overs or after massive weight loss associated with diet/exercise or with obesity surgery procedures (such as bypass or Lap Bands).
If you like the surgeon clarify this point with him. You may find out something you did not know before. If you are unhappy with his response only then seek a second opinion.
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Rectus Muscle "tightening" is part of an abdominoplasty!
An abdominoplasty should include excision of excessive skin and subcutaneous tissue, rectus muscle fascial plication (muscle tightening), and umbilical repositioning. A panniculectomy, which is sometimes performed after weight loss surgery, would include removal of infraumbilical skin and subcutaneous skin only. Panniculectomies are generally performed in patients who still have high body mass indices (BMI's) but suffer from the effects of hanging lower abdominal skin.
Muscle repair with Tummy tuck and abdominoplasty following gastric bypass or multiple births
The story you describe does not sound accurate. Gastric Bypass is not a contra-indication to muscle repair and so I am confused. MR can easily be performed following gastric bypass and is almost mandatory in following multiple pregnancies in order to acheive an optimal result.
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Muscle Tightening Limitations
Having had prior surgery should not affect the muscle repair. If there is a large hernia, I will repair that and be more conservative in tightening the muscles so there is not too much tension on the repair.
Otherwise, muscle repair should be done as tight as is needed to restore the abdominal contours.