I am scheduled for my full tummy tuck in 2 weeks. The doctor said that I don't have much abdominal muscle separation at all only around the umbilicus. If I opt to have the doctor not bind my muscles will this have an impact on the look of the tummy tuck? Will this make my recovery faster? Will this most likely be a decision that I regret if I don't get the muscles stitched? Does binding the muscles during tummy tuck make a big difference over not binding? Any advice would be great.
Muscle Binding During Tummy Tuck
Doctor Answers 9
Tightening Abs with Tummy Tuck
Most tummy tucks involve tightening of the rectus muscles. Most women who have been pregnant or lost a significant amount of weight will have a separation between the muscles that should be corrected.
If your surgeon does not feel that you need the tightening, then you will probably have a faster recovery with less pain.
If you have any questions, then be sure to see other surgeons and get multiple opinions. Choose the surgeon you are most comfortable with.
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Is Muscle Repair NECESSARY in a Tummy Tuck
Before answering your question directly, I need you to close your eyes and visualize what your tummy looked like before you became pregnant and the way it looked along the way. (The same applies to obese individuals who lose weight). As your tummy grew EVERYTHING on the outside was stretched - muscles, muscle lining and skin. With few exceptions, after delivery (or weight loss), there is no springing back of all the stretched tissues to their original conditions.
In a Tummy Tuck, we are in effect taking in loose tissues. To take in only loose skin and ignore the muscle is a MISTAKE. Such patients are robbed of the flatness the Tummy Tuck can easily get them which is very unfortunate.
For a good result, every stretched and loose component needs to be tightened. a good muscle repair will get you a much flatter tummy and a narrower waist (not achievable by skin removal only). A High Lateral Tension Abdominoplasty (Lockwood) would further flatten the tummy, lift commonly sagging privates to their proper location and tighten and lift sagging thighs.
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Dr. P. Aldea
Tummy tuck muscle plication
Even though you don't have a lot od separation, there will likely be stretching all along the fascia. If the doctor feels that it will make a significant difference, you should consider trusting him or get a second opinion.
Muscle plication or binding is what hurts, and hutrs a lot. Also it prolongs your recovery, but it is also what gives the procedure its powerful results.
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Muscle tightening in almost all tummy tucks
In women who have been pregnant it is virtually never the case that at least some muscle tightening wouldn't be of benefit with the tummy tuck. You might have a little less discomfort early on in the recovery without the muscle repair but you will likely regret not getting the flattest abdomen you could have had when you are all healed in a month.
Skin only tummy tuck (abdominoplasty) without muscle repair.
Muscle plication is generally considered a routine part of a tummy tuck procedure. Only rarely is it not indicated and this is most typically in massive weight loss patients who are males or females without a history of pregnancy. In my experience, only 1 out of 30 post partum females has an intact rectus muscle configuration. If you are one of these, then a core strengthening and skin only abdominoplasty may provide you with an excellent outcome.
Go with the surgeon's recommendation on muscle plication with tummy tuck
From your description it sounds like the surgeon is leaving it up to you, rather than making a recommendation. Since I can't examine you personally I can't comment on your case too specifically but almost always the result is better long-term with muscle tightening in my experience. Go with your surgeon's advice.
Less pain without muscle plication during Tummy Tuck, but result may be lesser
There are definitely patients for whom I don't do muscle plication. The vast majority of patients benefit from some plication if just below the belly button. It will make the procedure less painful NOT to plicate and your recovery will be faster.
Muscle tightening during tummy tuck
In general, muscle tightening during tummy tuck is effective in reducing abdomen bulging following pregnancy or weight loss. It is something I perform in about 99% of my tummy tucks.
It does make the recovery a little harder because of the muscle soreness that you need to recovery from afterwards. If you have very tight muscles already then you may be one of the lucky few who do not need muscle tightening with your tummy tuck.
It is impossible to know without seeing you in person if you would benefit from that or would regret not having it done. I would trust in the doctor who is going to do your surgery about whether it is needed in your case.
Robert Pollack, MD
Muscle plication in abdominoplasty
I do not always tighten the muscles surgically. Your surgeon should try to determine if your contour is a result of skin, muscle, or fat. Often most of the contour is determined by skin and muscle.
Tightening the muscles does increase risks due to increased intra-abdominal pressure and post-op pain, and may not alter contour significantly. Your surgeon should check your muscle tone and posture. Often these have more to do with contour than the muscle, especially if the muscles are normal anatomically.