Tightening muscles does not make them stronger
Muscle tightening only improves appearance of stomach. It does not impact muscle strength or muscle function
Is it possible to have muscle repair just to help strengthen muscles, even if no repair is required
The muscle repair that is performed only moves the muscles into their original position. The repair, in and of itself does not make the muscle stronger, and tightening muscles that are not loose will do nothing to improve strength.
Suturing of the rectus muscle should only be done if there is laxity or separation of these muscles after weight gain/loss or childbirth. There is no evidence that this maneuver helps back pain and there is good data to suggest over tightening can lead to more serious complications, like blood clots in the legs, as an example. Talk to your surgeon about your concerns. Good luck with your TT!
Muscle Repair, "Core" and Back Pain
Back pain is caused by many causes. It is rare for repair of a small muscle separation of the abdominal wall to improve on severe back pain. In other words, there are several reasons for a muscle repair as part of acTummy Tuck (such as a history if multiple children) but this is not one of them. Dr. Peter A. Aldea
The concept of universal muscle repair for all tummy tucks is without academic support and is an assumption based on a long history of advocates of muscle repair in cosmetic surgery. As a practicing general surgeon before I became a plastic surgeon I was able to have a different perspective than most plastic surgeons on this issue. In addition i authored the chapter on abdominal wall reconstruction in Reoperative Surgery by Grotting et al and have many years of experience in repair of massive defects in the abdominal wall and am an expert on andominal wall function. While good abdominal wall function is necessary for proper bowel function , and yes there are patients who benefit from from diastasis repair , and yes better abdominal support will help back pain from muscular origins , it is not universally necessary as previously thought and a mild diastasis is not going to affect function whatsoever, nor will the repair of a mild diastasis cure back pain . This can be easily noted by seeing the participants in female bodybuilding who have flat tummies yet an obvious and visible diastasis. I have a number if these girls in my practice and while we have tightened skin it would have been wrong to repair the diastasis as they didn't need it. Also you don't have to be a bodybuilder to have strong well functioning muscles and I have found we are over reoairing way too many patients which extends the recovery significantly. In fact it was shown by Jansen , et al that the overwhelming majority of tummy tuck patients who undergo a diastasis repair have virtual complete relaxation of the repair within a year thus making the painful recovery associated with the muscle repair unecessary. There is no study comparing patients with muscle repair to those without that shows an improvement in muscle repair. So, your surgeon who feels you likely don't need this is trying to save you from a painful recovery and I am sure would not offer this if he felt your result would be compromised. Ask to see pictures of patients who did not have a muscle repair and you can see for yourself. If in the end you want to have a muscle repair (if a diastasis is present at surgery) then just talk with him and I am sure he will oblige as long as you understand the significant difference in recovery
Possible to have muscle repair just to help strengthen muscles, even if no repair is required?
Thank you for the question. Generally speaking, the vast majority of patients who present for tummy tuck surgery benefit from muscle plication; as you know, this part of the tummy tuck procedure serves to re-approximate the muscles that have spread during pregnancy or weight gain/loss. Omitting this part of the procedure will potentially leave patients with continued abdominal wall laxity and, in my opinion, a less than optimal result. If you remain in doubt, seek additional consultations with well experienced board certified plastic surgeons who can demonstrate significant experience helping patients achieve the types of outcomes you would be pleased with.
Thanks for your
inquiry. The muscle repair won’t
necessarily make the muscle stronger, it may help with the core strength
somewhat, but it won’t effect the strength of the muscle itself. I will say that most often than not the
muscle is repaired during a tummy tuck surgery.
I would recommend discussing it further with your surgeon. Best of luck.
Tightening Muscles Does Not Improve Strength
Simply tightening the stomach muscles will not increase their strength. It does flatten the stomach. In a few cases if there has been a significant stretch of the linea alba (the strip of tissue down the middle of the stomach wall between the two rectus abdominus muscles), tightening of the linea alba can re-orient the pull of these muscles back to their original and proper direction and improve their efficiency.
Tightening abdominal muscles does not strengthen core
Surgically reapproximating the rectus muscles during abdominoplasty will do nothing to strengthen your core. It only allows for optimal contouring (appearance) of your abdomen.
A muscle plication is usually a good thing to do at the time of an abdominoplasty in a patient who has had pregnancies (you did not say if you did). Pregnancy stretches the muscles and it is rare to have them come back to the mid-line as they were before the pregnancy. It is true that the muscle repair will relax some over the next year, but at least the surgeon and the patient know that they did everything they could to make the patient's abdomen as flat as possible.I would never recommend a muscle plication to try to "strengthen" the muscles. It will not result in more strength, if anything the rectus muscle plication weakens the muscle by putting the big stitches in them and creating more scar. It is not the same as having good core strength.The relationship between muscle plication and helping with back pain is too hard to sort out. Back pain has so many factors. I never tell my patients that muscle plication will be good for back pain, I tell them it may help, but I never promote that as a reason to do the muscle.Thanks,Gordon Telepun, MDDecatur, Alabama