Tummy Tuck: Q&A
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Should Stomach Muscles Always Be Tightened During a Tummy Tuck?
I'm scheduled for a full TT with some lipo and BA. I've had 4 pregnancies but my stomach muscles have not separated, only a fingertip space between them when flexed below and above the belly button. I'm 5'3", 125#, 39 yrs, exercise and workout core regularly. I have loose, stretch marked skin and poochy stomach fat I can't get rid of. My surgeon says I won't need a repair. But should I ask for them to be tightened anyway to get the best results from the TT? Or would it not make any difference?
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22 Doctor Answers |
Asked by
UGAgirl
in Florida
+4
Have your muscles tightened.
Thank you for posting your photos. It helps a lot. The second photo shows you leaning over with tightened muscles. The very right photo you have relaxed muscles. There is a big difference which tells me there is abdominal wall laxity that will be improved with muscle plication. You will get a flatter stomach that will last you longer if you have your muscles tightened. You will not always be 39 and 20 years after my own TT I can honestly say that...
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+3
Should my muscles be tightened with a tummy tuck
I don't think that I have seen a woman after 4 pregnancies who would not benefit from having the muscles tightened. It will help you get a tighter, flatter stomach. It does hurt more for the first few days and does somewhat prolong the recovery and cause some limitations in activity for a longer period of time. I do not let my patients perform any abdominal or core exercises for 6 weeks after having the muscles tightened. That being said, it is entirely elective...
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+3
There's no good reason NOT to tighten the muscles in a tummy tuck
You only get one shot at a great result with a tummy tuck and after 4 pregnancies, I can virtually guarantee you that you would have a better flatter result with some appropriate muscle tightening performed. It is quick, easy, and only adds a little temporary pain in the recovery but dramatically improves the result.
I have done several TT's this week and in one the muscles were 2-3 inches apart and in another they weren't apart at all. However, both had equal...
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+2
To tighten the muscles
After looking at your photos I would say yes to tightening your muscles a little.It will be a little more uncomfortable post op but well worth it.
+2
If the muscles are together, no repair necessary.
The term "muscle tightening" is a misnomer when applied to a tummy tuck. What is performed is a plication, or folding, of the fascia of the abdominal wall to correct bulging that occurs when the abdominal wall is lax. This commonly occurs following pregnancy as the rapid enlargement of the womb distends the abdominal muscles and stretches out the fascia. In some women, the abdominal wall recoils back to its original shape following pregnancy. In these cases, the abdominal wall...
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+2
Muscle Plication Is Sometime Not Needed with Abdominoplasty
Although you would get a flatter abdomen overall with plication (tightening of the muscle wall), because your muscle wall laxity is limited and the majority of your skin laxity is low, you can elect NOT to have the plication. This will make your surgery less painful and shorten your recovery.
When I do perform plication, I use a pain pump which drips Marcaine onto the plication for the first 3 days. This decreases the pain significantly.
If you were my...
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+2
If you are not planning any more pregnancies,
Then you should have your muscles plicated at the same time as you have your body contoured and the excess skin on your abdomen removed. This is of course if your muscles have drifted apart enough to require plication. Some of my patients only require tightening of the lower half of the abdomen, and many require the entire abdomen to be tightened up. Your plastic surgeon should examine all of your 'layers' (muscle, fat, and skin) and give you options for each layer. ...
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+2
Should Stomach Muscles Always Be Tightened During a Tummy Tuck?
Abdominal muscle (Six pack / rectus abdominis) separation is NOT the only irreversible damage brought on by pregnancy. The fact that a lime sized uterus becomes the size of a large watermelong and maintains those dimensions for monthS, means that the abdominal wall (muscles and skin) had to stretch and finally split to accomodate such a large intra-abdominal mass. Even if there was not a significant splitting of the muscles you can BET that the abdominal cavity is much larger and the...
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+2
Should Stomach Muscles Always Be Tightened During a Tummy Tuck?
I'm answering your specific question of YOU having your muscles repaired while you are having your TT. Understand none of us, expert posters, have examined you in person, so your chosen surgeon has an advantage over us. If he believes you do not need a MR than either he is correct or he mis diagnosed you, I can not say. Just to be sure have the muscle repair done to avoid that issue. It might not matter in the final evaluation of your result, but if you do not that if you have a...
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+2
Muscle repair after multiple pregnancy
During tummy tuck muscle repair is a rather easy step and it is hard to imagine after four pregnancies that you would not benefit. The fact that you can place a finger between the sit-up muscles confirms the separation of the muscles or diastasis. Before pregnancy I doubt that you could do that. Certainly every tummy tuck should be individualized, but don't let the recovery dissuade you from the best result.
Best of luck,
peterejohnsonmd
+1
Should Stomach Muscles Always Be Tightened During a Tummy Tuck?
I love these easy ones: after 4 pregnancies you ABSOLUTELY need to have a muscle repair.
Good luck!
+1
Muscle plication during abdominoplasties.
It will make a difference if you do not do the muscle plication your abdomen will not be as flat nor as tight. If a person had several pregnancies the muscle certainly has separated to some degree and it is difficult to tell by physical exam sometimes.
+1
Tummy tuck
In you situation where you have had four pregnancies I would normally plan to tighten the muscles. It is very rare that I perform and abdominoplasty and do not plicate the muscles.
+1
Muscle Tightening with Tummy Tuck
I have never seen anyone having a tummy tuck who did not need a “muscle” tightening. Although you say your muscles are close together with flexing, they are not that way when your muscles are relaxed. The fascia (the tissue that holds everything together) stretches with time and, especially, with pregnancy. We tighten this fascia to keep the muscles in normal position even when your muscles are not flexing.
Highlands Plastic Surgeon
+1
Muscle tightening during tummy tuck
Four pregnancies will usually result in some degree of muscle laxity which would benefit from abdominal wall muscle tightening. Although not severe, your photos confirm this and adding a muscle plication would most likely enhance your result.
+1
Muscles Should Almost Always Be Plicated During Tummy Tuck
There are some circumstances in which the rectus muscles do not need to be plicated or tightened during a tummy tuck, but they are rare and you should have this as part of your tummy tuck. Any woman, such as you, who has had 4 pregnancies will benefit from a muscle plication. I have seen a few patients, mainly those without pregnancies, who do not need a plication.
+1
There is no right answer to muscle tightening during tummy tuck
In general most women who have delivered babies will have some element of diastasis of the rectus muscles. That being said the decision to tighten the muscle fascia is a clinical one based on what is seen on examination and during the surgery. Often times I tighten the muscle fascia to narrow the waist and to get a more pleasing hour glass shape. You should trust your board certified plastic surgeon and discuss your concerns with him or her.
+1
Fascial Plication During Abdominoplasty
Body contouring operations are very patient specific. With respect to abdominoplasty, the amount of fascial plication varies depending upon individual needs. The amount of separation between the rectus muscles may vary significantly between women; but usually the more separation that is present between the muscles, the more the abdominal wall protrudes in the standing position.
Your pictures show that you have been much luckier than some women, and have not developed the degree of...
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+1
Muscle repair during tummy tuck
Procedures should be tailored to individual patients. During surgery with muscle relaxation, additional laxity may be apparent that is not appreciated during an office visit exam. If there is no laxity when you are under anesthesia, there is nothing to be gained by tightening the muscles further. Muscle tightening ("fascial plication") is the major cause of post-operative discomfort during a tummy tuck, plays the greatest role in post-operative activity...
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+1
In medicine there is no always
I almost always tighten the muscles. There are some rare times I don't, but most of the time the result is improved by fixing the diastasis of the recti muscles
+1
Should muscles always be tightened in tummy tuck?
I agree that after 4 pregnancies, there may well be some laxity in your abdominal muscles. However, I do not always tighten the muscles. If there is no obvious stretch between the muscles when you flex them, then I make an assessment on the table, and only if there was a space between them, would I suture them back. No intervention is without complications and it does make it a little bit more uncomfortable when the muscles are repaired.
Birmingham Plastic Surgeon
+1
Muscle tightening and tummy tuck
My opinion is that every surgical procedure should be customized to each individual patient.. Your surgeon should test your muscle tone and posture. If both are normal, I feel there is possibly no reason to tighten the muscle passively with sutures. Suturing the muscle can increase pain and over-tightening can increase intra-abdominal pressure. Both can lead to prolonged recovery, increased use of narcotics, and possibly deep vein thrombosis and pulmonary embolism....
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