No Muscle Tightening After Tummy Tuck?

I had a Tummy Tuck about a year ago. My tummy is functionally satisfactory; the apron is gone but cosmetically less so. My flanks bulge and the surgeon kept my navel, even though it's much darker than the rest of my tummy. Most annoyingly, if I don't hold it, I have this hanging globular abdomen again. Is this normal after Tummy Tuck? I am starting to believe that my surgeon did not attempt any muscle tightening. Am I right?

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11 Doctor Answers | Asked by asbestos in London, UK

Doctor Answers (11)
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Get to the Core of the Issue

During Abdominoplasty, the plastic surgeon often plicates (tightens) the lax abdominal muscle fascia. Diastasis Recti (separation of the rectus abdominus strap muscles which run vertically down the abdomen from ribs to pubis) often results from aging and is especially common after child bearing, particularly with multiple pregnancies. In some cases of mild diastasis, it is unnecessary to plicate the muscles at all. Nevertheless, even if the midline of the rectus muscle is plicated, there... more

"Muscle tightening"

Many surgeons refer to "tightening of the muscles". This is in fact never done during a tummy tuck. Rather, the fascia, the tough lining of the muscles, is tightened. Almost always during a full tummy tuck, the fascia is tightened, unless there is a specific reason not to (i.e. a massive weight loss patient who intends to have children shortly but needed the apron off). Many patients are under the misconception that if the deep layer (fascia) is teightened, the stomach will be... more

Muscle work - the surgeon's and yours

As mentioned in the previous well written answers, most abdominoplasty procedures entail muscle tightening as a component of the procedure. Just like everything under stress, the abdominal wall stretches after abdominoplasty, just as the skin relaxes. After an appropriate amount of time for recovery, it then becomes necessary to exercise the abdominal muscles the maintain the results of surgery, not to mention experience the many positive benefits of core muscle strength. If you are... more

Muscle tightening is not always indicated.

To asbestos, Depending on your anatomy, muscle tightening can actually make your waistline look worse. But this is the exception. The real issue is that you are dissatisfied. You just need to go back to your surgeon because, very likely, you can be happier with a revision.

Discuss your concerns with your plastic surgeon, as you may need a tummy tuck revision

The comments and points made by the other physicians are spot on as it applies to the abdominal muscle and whether or not the muscle/fascia layer was tightened. I would like to address the second part of your question that is directed to the “flanks” that now “bulge”. This is a common problem that I have seen following a tummy tuck (abdominoplasty) procedure. The bulging flanks are indicative that your plastic surgeon has, indeed, tightened the muscle/fascia layer... more

You might have gained weight after your tummy tuck

I don't know exactly what your surgeon did, but if your abdomen did initially appear tight after surgery, and then it started to bulge gradually, then this could be because of you gaining weight. I have had patients who have not watched their diet afterward and have gained weight. Often times, the added weight accumultes in the intestinal fat or "viseral fat," which causes the abdomen to bulge out. First, try to lose some weight and then talk to your surgeon.

Diastasis recti usually tightened

Muscle are not tightened during abdominoplasty. This is a misnomer. Actually what is treated is the stretched midline fascia that overlies the muscle and connects in the midline. Loose skin as well is treated by excising redundant tissue inferiorly at the level of the mons pubis. If the skin is very loose, then perhaps more skin shuld have been removed. However, there should be a little laxity that you appreciate when sitting and that flattens out when you stand. If it is made too... more

Steven Wallach, MD

12 reviews

Manhattan Plastic Surgeon

If you don't use it, you lose it!

I don't know whether you had a muscle plication during your tummy tuck, or whether or not you actually needed one. However, one thing I am sure of is that if you don't workout to maintain a healthy weight and tighten the core abdomenal muscle, you will have what you are describing. Pilates is a great way to work on those abs - so get working!

Belt lipectomy versus tummy tuck

It is difficult to assess your description without the use of a photograph. However, it sounds as if you have significant intra-abdominal fatty deposits as well as circumferential laxity that would better be treated with belt lipectomy. A muscle repair would do little to effect your flanks whether or not it was performed. see video

Otto Joseph Placik, MD

32 reviews

Chicago Plastic Surgeon

Not all tummy tucks demand tightening of the muscle.

Your surgeon should have explained to you all that was to be done during your operation and what to expect. Tightening of the fascia (muscle covering) is not necessary in all patients. If you do not like the result, you should take this up with your surgeon. Some protuberance may eventuate even with fascia tightening.

Muscle tightening after a tummy tuck

Tummy tucks are an extremely popular and effective way to contour the abdomen. In our practice, no two tummy tucks are the same as we customize each tummy tuck for that individual patient. Many of our patients, especially after childbirth, have loose muscles. We can tighten the muscles with different suture techniques. This creates a flatter tummy and a tighter waist. If you are concerned about the tightness of your tummy, it may be possible to do a small revision of your surgery and... more