Tummy Tuck with no Muscle Repair, will results be compromised? And how soon can it be fixed to minimize downtime?

I'm 2 weeks post LBL and BL. I had concerns preop because my PS told me he did not think any ab muscle repair was necessary. Pre-op I was 5'8, 134 and in very good shape, I lost 150lbs and had excess skin. My PS said I didn't have fat to lipo, it was all skin. Preop I said it was my strong preference to have muscles repaired if there was any laxity. After he told me no muscle repair was needed or done. I'm concerned this is why I now have small pouch instead of the flat stomach i hoped for?

Doctor Answers 9

Wait for swelling to go away first

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You may want to wait for a few months before you assess your results because at the moment, you're still swollen. This could be why you've got a pooch. Maintain in close contact with your surgeon until then so when you don't see your results in a few months, you can return to them and discuss revision.

Tummy Tuck and muscle repair

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Thank you for sharing your story. I apologize for your apprehension regarding your final results and without your photos of before and after, it is nearly impossible to offer guidance regarding this issue. Although it can be very difficult to remain patient, when you are only 2 weeks post op, there is a lot of swelling still present. You truly cannot evaluate your “final results” until approximately 3-6 months post op. I would encourage you to share your concerns with your plastic surgeon and discuss post operative recovery recommendations in order to help reduce swelling and enhance your recovery process. Stay patient – good luck!

Stanley Okoro, MD
Atlanta Plastic Surgeon
4.7 out of 5 stars 168 reviews

Repair of the fascia and muscles not always necessary with abdominoplasty.

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If laxity of the fascia is a component of the abdominal problem it seems unwise not to correct. However, if it is not been this portion of the procedure can be deleted.

Muscle repair with Tummy tuck

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Muscle repair are not always needed with the Tummy tuck maybe that's why you didn't get this procedure. I can't tell without seeing your photos. You should wait the 3-6 months and if your don't like your body then visit your Plastic surgeon and discuss this with him/her.

Good luck!

Yily De Los Santos, MD
Dominican Republic Plastic Surgeon
4.3 out of 5 stars 1,743 reviews

Tummy tuck with No Muscle Repair

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Thank you for your question. Without examing you it is difficult to say if muscle tightening is the cause of the pouch. At two weeks post-op, it could be swelling or a fluid collection. Typically, muscle tightening is part of a tummy tuck after pregnancy or massive weight loss.

Muscle repair or not

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I cannot comment on your case specfically.  Typically after 150 pound weight loss one has primarily a skin elasticity problem.  I,too, routinely tighten the muscles to avoid a lower abdomenal pooch.  There are people who do not require a muscle repair, but they are rare.
Muscle repair makes the post op recovery longer

Robert S. Feins, MD, FACS
Manchester Plastic Surgeon

Abdominal wall tightening with tummy tuck

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Although every patient is different in my experience I have found that most tummy tuck patients benefit from abdominal wall tightening (muscle repair).

Pregnancy and weight loss are common reasons to seek a tummy tuck procedure and also the reasons that abdominal wall tightening is often beneficial. 

All the best,

Dr Remus Repta

Remus Repta, MD
Scottsdale Plastic Surgeon
4.9 out of 5 stars 173 reviews

Tummy Tuck with no Muscle Repair, will results be compromised? And how soon can it be fixed to minimize downtime?

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Although I cannot comment on your specific situation, the tummy tuck procedure typically involves plication  of the abdominal wall muscle that have spread during pregnancy or weight gain/loss. Omitting  this part (for the vast majority of patients) of the procedure will  otherwise leave patients with continued abdominal wall laxity and, in my  opinion, a less than optimal result.  At this point, given that you are only 2 weeks out of the surgery, I would suggest continued patience;  it will be several months and even up to one year before you see the final outcome of the procedure performed. That will be the time to evaluate the need for revisionary surgery. Best wishes.


Tummy tuck with no muscle repair

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We are finding more and more that muscle repair is unnecessary in many cases and the fact that something is "typical" does not mean it is necessary. In fact if you look at the history of the repair of the midline muscles in surgery extending all the back to the 50's there was a procedure that was called "the darn" and it was very popular among general surgeons for repairing eventrations ( a bulge). However, it was finally declared as a procedure that did not work and it was abandoned. Plastic surgeons picked it up again when they began to tighten muscles during abdominoplasty repairs in the ensuing years. However, in an overlooked study done in the 90's by a plastic surgeon in New Orleans, Dr. David Jansen, he was able to show that a year after muscle tightening there was significant relaxation of the repair in most all patients. While there are no question some patients who would benefit from abdominal muscle repair or tightening, we are finding that in most cases it is not necessary and an excellent result can be obtained from skin and fat contouring alone. While I cannot be sure without an exam. it sounds as if you have seroma which is collection of fluid beneath the lower border of the flap which is fairly common in abdominoplasty. We usually aspirate this weekly until it is gone to prevent it from causing a permanent distortion in the result, however, most of these do resolve spontaneously as the body absorbs the fluid.

Grady B. Core, MD
Birmingham Plastic Surgeon
4.6 out of 5 stars 13 reviews

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.