How to fix abdominal separation appearance after TT and MR? (Photo)

You have a great result. If you look at how wide your diastasis was, likely the muscles themselves were stretched (not just separated).

Since CT scan confirms that your muscles are together, the only thing you can do is strengthen them. If working out isn’t enough, the Emsculpt or Emtone device can improve muscle tone. It requires twice weekly sessions up front and maintenance sessions after that.

Hello, and thank you for your question regarding how to address the appearance of abdominal muscle separation after undergoing a tummy tuck with muscle repair and umbilical hernia repair. I appreciate the details you've provided, including your history, CT scan results, and pictures.

Based on the CT scan confirming that there is no rectus diastasis (muscle separation), it is unlikely that your abdominal contour concerns are due to a failed muscle repair. Instead, several factors could contribute to the appearance of separation, including residual swelling, differences in muscle tone, variations in fat distribution, or even the natural way your muscles are structured.

One common reason for a lingering "separated" look is the natural anatomy of the rectus abdominis muscles. These muscles have a central linea alba (a band of connective tissue) between them, which can sometimes create an optical illusion of separation, especially in individuals with low body fat. Additionally, postoperative swelling or changes in skin elasticity can create a shadowing effect along the midline, emphasizing the appearance of a gap.

If you desire a closer, more defined muscle appearance, the best non-surgical approach would be targeted core exercises to build muscle tone and enhance abdominal definition. Strength training and high-tension exercises such as planks, Pilates, or resistance training can help tighten and bring out the definition of your abdominal wall. Non-invasive body contouring treatments such as Emsculpt, which uses electromagnetic stimulation to strengthen and firm the muscles, may also help refine your abdominal contour.

Since your CT scan confirmed that your rectus abdominis muscles are intact and well approximated, most plastic surgeons would agree that further surgical revision is unnecessary. However, if you remain concerned, I recommend discussing your specific aesthetic goals with your surgeon to explore personalized options.

Thank you for your question regarding how to improve the appearance of abdominal separation after muscle repair. If you have any additional concerns, consult an experienced, board-certified plastic surgeon with expertise in tummy tuck surgery.

Sincerely,
Dr. Katzen

Thank you Elise for posting your question here.Let me start by stating that my answer is based on the limited information and pictures provided, for a more bespoke plan I would recommend consulting with a plastic surgeon.
From the pictures it appears that you had a good outcome so congratulations on taking that step , the separation you are seeing after the surgery can be attributed to many factors which is hard to determine based on the information provided , some examples include:
- muscle weakness and stretch, the way to fix that is by strengthening your core and exercise- if a lipoabdominoplasty (liposuction in addition to the abdominoplasty) was performed which I doubt since you didn't appear to have much fat pre-op, but in certain individuals the surgeon might intentionally form that groove either by trimming fat manually or through liposuction as to give the patient a more athletic look. fixing that might be a little challenging , you can try fat grafting but the results will vary and there are no guarantees.- for your lower abdomen I am not sure if it is the case or not as it is hard to tell from the picture but you seem to have a vertical component to your incision, which sometimes is necessary when the bellybutton is high naturally, this sometimes if the deep tissue is not brought together might appear a little hollow , and sometimes the scar contracts in a way that appears as a groove if tethered to the underlying tissue. In that case a scar revision can help.I hope this helps, best of luck!

Hello,Before the surgery, there was a significant rectus diastasis and umbilical hernia. These were very effectively corrected through the operation. The rectus abdominis muscles are not closely aligned at the midline. There is a connective tissue band, known as the linea alba, formed by the anterior and posterior fasciae of the muscles on both sides. If this connective tissue band becomes very weak, rectus diastasis occurs. The current appearance is quite good and is the expected result.

From the submitted photos and description it seems you have a very nice result to your tummy tuck. As there is no diastasis I would suggest continuing to work on your core strength. Your result looks very natural.

Hello, thank you for the question and the pics. Your tummy tuck seems very rightly done, and you have a good result. it appears that because of the diastases, your subcutaneous tissue in the midline was a bit thinner than usual. The "separation" above the umbilicus, doesn't bother me, in fact it makes your abdomen look natural, altogether while being flat, I would be a bit more bothered by the line under your navel, and you could have a couple of sessions of fat transfer directly on the midline dent to simply even it out with the lateral part

It’s a bit difficult to make equality assessment with the provided information.
I wonder why you believe you have muscle separation after surgery? Generally, there are four variables that determine what the abdomen looks like.
These are.
1) Abdominal laxity typically due to weight loss or previous pregnancies.
2) Excess subcutaneous fat.
3) Muscle separation from previous pregnancies.
4) Excess visceral or intra-abdominal fat.
Muscle separation is usually assessed by how much the abdominal wall bulges.
Excess visceral fat can also put pressure on the abdominal wall, causing it to bulge. You don’t appear to have significant skin and your subcutaneous fat layer is small.Make sure you have a clear understanding of what variables are contributing to the appearance of your abdomen before having revision surgery.
Re-tightening of your muscle wall if it’s not indicated is simply going through a highly invasive operation with little benefit.
I suggest you rely on in person second opinion consultations with other plastic surgeons.
For second opinion consultations come prepared bringing with you a complete set of proper before and after pictures and a copy of your operative report.
These are all part of your medical records that you can request from your current provider.It would be helpful if you could describe what your concern is.
Best,
Mats Hagstrom MD