A friend is actually concerned because she experienced very minimal muscular pain after a full tummy tuck. Is it possible her surgeon either skipped it or did a poor job? He does have an excellent reputation and her stomach does look pretty flat, but she'd rather not challenge him if there is a reasonable explanation for the lack of pain.
How Do You Know if a Surgeon Did Muscle Plication During Tummy Tuck?
Doctor Answers (9)
Tummy tuck muscle tightening
Muscle plication is widely performed during abdominoplasty, except during a small percentage of patients who have only skin and fat redundancy but tight musculature. The easiest way to determine is to ask your surgeon, or seek the advice of a plastic surgeon.
My friend has little pain after a tummy tuck. Did the doctor do a muscle plication?
More pain or less pain after tummy tuck
I think there is a significant variance to some patients pain tolerances and to the degree certain surgeons perform the muscle plication. I would guess the best way to know if your surgeon plicated the muscles is to ask them. You can always request a copy of the operative note, also. Its difficult to gauge every patient experience as some patients can get more pain with less surgery and some have wild pain responses to the same amount of surgery.
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Check with your surgeon about plication
Pain differs greatly from one patient to the next for the exact same procedure. If the result is excellant, and was achieved with minimal pain this is great. If she must know, then ask the surgeon and/or request a copy of the operative note.
Muscle plication during abdominoplasty
I almost always do a muscle plication during a tummy tuck. The simplest way to find out if the surgeon performed this portion of the operation is to ask.
Does muscle plication with tummy tuck always cause pain? No!
Let's see, her surgeon has an excellent reputation, she has a good result, and she is upset because she doesn't have as much pain as she anticipated, and "therefore" her plication must have been skipped. Please give her surgeon a break; if she had had more bruising and pain, then would she have "known" she got all the surgery she paid for? Still, there's that nagging doubt . . .
Though tummy tucks are usually not pain-free, any surgeon will tell you that post-operative discomfort is quite subjective and varies widely among our patients, regardless of operation. As others have noted, perhaps her surgeon does as I have for years and injects a long-acting local anesthetic in the muscle sheath and the incisional edges (as well as drain site) so that the patient actually wakes up comfortable and without muscle spasm or incisional pain! Perhaps a pain pump was used. Plication sutures the muscular fascia (the sheath of "gristle" surrounding the muscle) to bring the rectus abdominis muscles (the "six-pack" muscles) back together to their pre-pregnancy, unstretched, midline position. These sutures should ideally not go through muscle fibers, which avoids localized bleeding, bruising, pain, and spasm.
It IS possible a plication may not have been done; despite having had children, not every woman actually NEEDS plication for a good result. If she doesn't trust her surgeon to use his best judgement, she should not have had him operating on her. Likewise, if she trusts her surgical procedure to him, she should feel comfortable asking him directly, in a non-threatening manner, if he performed plication during her tummy tuck. Any ethical surgeon will have no problem being truthful (either way), and she should stop "second-guessing" her surgeon. Can she be trusted to follow his post-operative instructions? And if things don't turn out as anticipated, whose "fault" will it be then?
Painless tummy tuck: Was muscle tightened?
It surprises me that your friend is upset that she had an excellent outcome with no pain. Pain is a very subjective complaint with some patients experiencing minimal while others report excruciating pain with the exact same procedure being performed. The simplest would be for your friend to ask the doctor if a muscle plication was performed. Generally speaking, lying down with your friends arms at her side, ask her to lift her head using her stomach muscles only. You should be able to see the muscle repair or lack thereof.
"How Do You Know if a Surgeon Did Muscle Plication During Tummy Tuck?
Regarding : "How Do You Know if a Surgeon Did Muscle Plication During Tummy Tuck?
A friend is actually concerned because she experienced very minimal muscular pain after a full tummy tuck. Is it possible her surgeon either skipped it or did a poor job? He does have an excellent reputation and her stomach does look pretty flat, but she'd rather not challenge him if there is a reasonable explanation for the lack of pain."
Believe it or not, the lack of Tummy Tuck pain is NOT indicative of the extent of muscle repair. A significant muscle repair CAN be done without much discomfort if the surgeon uses pain pumps or numbs the muscle repair. I have been doing so in my practice for several years and have been rewarded with many happy patients who, just like your friend, cannot understand why they are NOT feeling the pain and discomfort they are SUPPOSED to feel.
Dr. Peter Aldea
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.