Can a muscle repair ever cause more harm than good? (Photo)

Regardless of what you've been told, actual separation of the the recti muscles is not the only thing that can cause a bulging contour. When you ask surgeons expert in tummy tucks, they'll tell you that they frequently tighten the rectus sheath beyond just bring the muscle together. This is because the actual fascial sheath of the muscles can elongate. Looking at your photo, you have a minor bulging at, and slightly below the umbilicus, and a muscle repair would be helpful to fix that and help bury the umbilical stalk for maximum depth, which is another issue you have: too little fat to make the belly button look natural. However, with some skill and a muscle repair, you'll get a much nicer belly button than you have now. Yes, a little lipo in the flank will help. Here's an important side note: You need a surgeon who will place your long transverse incision very, very low, which will mean that you will also need a vertical incision as well to repair the hole left from detaching the abdominal skin from the belly button. This is the most aesthetically pleasing way to do it. Again, super low long incision and a relatively short vertical incision.

Hello Lindaw. Thank you for your question regarding the potential risks associated with muscle repair during a tummy tuck and the effectiveness of flank liposuction in achieving an hourglass figure.

Your consultations have highlighted a crucial point: not all tummy tuck procedures require muscle repair. Muscle repair, also known as rectus abdominis plication, is primarily beneficial for those with significant muscle separation due to pregnancy, weight fluctuations, or other factors. Since you have minimal muscle separation, opting out of this additional procedure is a wise consideration given your circumstances.

Potential Complications of Muscle Repair:

Pain and Discomfort: Improperly indicated or overly tight muscle plication can result in discomfort akin to constant post-workout soreness, extending from the ribcage to the pubic area.
Abnormal Anatomy Appearance: Overcorrection can lead to an unnatural flatness or blunting of the natural contours of the abdominal wall, potentially making it harder to achieve a defined 'six-pack' look if that is a goal.
Suture Rejection: There is a small risk associated with the permanent sutures used in the plication process. These can occasionally lead to irritation or infection, necessitating further intervention to resolve.
Flank Liposuction:
Regarding your query about liposuction of the flanks, its effectiveness greatly depends on the existing amount of fat and your overall body composition. In patients who are already lean, like yourself, removing small amounts of fat from the flanks may not dramatically change the silhouette into an hourglass shape. It could subtly enhance the contour, but it would not be transformative.

Given your specific anatomy and the feedback from multiple consultations, it seems more prudent to focus on addressing the excess skin via a tummy tuck without muscle plication. This approach aligns better with your existing body structure and minimizes the risk of unnecessary complications.

Discussing these options thoroughly with your plastic surgeon will help tailor the procedure to your individual needs while avoiding over-correction. Remember, the goal of any cosmetic surgery should be to enhance your natural body structure in a safe and effective manner.

I hope this information helps clarify your concerns regarding muscle repair and flank liposuction. Good luck with your decision-making process and your upcoming tummy tuck.

Sincerely,

J. Timothy Katzen, MD, FASMBS, FICS
Plastic Surgeon

Thank you for your question. Muscle repair regains strength and functionality of the muscles after damage. However, it can sometimes cause complications if post-op instructions are not followed. However, to get an hourglass shape with slack abdominal skin, an hourglass tummy tuck is the most frequently advised surgery. It is a modified version of a regular tummy tuck that concentrates on achieving a curvier contour. This surgery involves liposuction around the back and flanks to firm the stomach and sculpt the waist, abdominal muscle restoration and tightening, and skin removal to create a smoother, tighter abdominal region. Remember that the ideal strategy varies depending on personal characteristics, including general health, desired cosmetic outcomes, and the degree of skin laxity.