Is a rectus plication always necessary with a tummy tuck?

Thanks for your question.   During a consult your surgeon can determine if you have a rectus muscle diastasis (gap between the muscles) that is repairable by doing a plication.  I perform a plication during most of my tummy tucks but if there is no significant diastasis it is not essential.  With any additional procedure done during an operation there are associated risks but generally diastasis repair is not associated with a high rate of complications.  This risk must be weighed against the benefit of an improved abdominal contour.  An plastic surgeon experienced with tummy tuck surgery and diastasis repair will be able to discuss this in more detail during a consult.

Rectus plication can be evaluate on physical exam when you come to your first visit. If you had children or had weight gain and loss most of the time you would benefit from rectus plication. 

Thank you for your question.  In general, most tummy tucks do have a muscle plication performed at the same time.  This is common because the same factors that lead to excess skin development (weight gain/weight loss and pregnancy) cause stretching and separation of the rectus muscles.  Muscle plication narrows and tightens the waist leading to an improved waist and body contour, while eliminating the possibilities of bulges that can develop if the muscles are not plicated back together.  A physical exam performed during your consultation can determine if you will need a muscle plication.  One is not riskier than the other, though a muscle plication does add time to the overall operation.  

A rectus plication is surgical repair of the abdominal muscles.  Most, but not all, patients desiring a tummy tuck need one, but the surgery can be performed without it.  Some of my tummy tuck patients have never been pregnant and don't need one.  Others have mild separation of the abdominal muscles (we call this rectus diastasis) but are planning to become pregnant, so I don't perform a plication.  The best way to know what you need is to meet with a board certified plastic surgeon.  If you want to get a general idea on your own, lay on your back and do a crunch.  While you are holding yourself up and tensing your abs, feel the area above your belly button.  If you have a separation in your abs, you might benefit from a rectus plication.

Greetings. In general, a rectus plication is usually performed during a tummy tuck to address any issues with diastasis. If it is not performed, there is a risk of abdominal wall laxity. It would be best to discuss your concerns with a consultation with a plastic surgeon.  Good luck!

The great majority of patients that I see regarding a Tummy Tuck (Abdominoplasty) have had children and therefore have the separation between their muscles that is necessary for a baby to have enough room to grow in a woman's abdomen. Occasionally I do see patients who have lost weight and have excess abdominal skin but have never been pregnant. In these patients removal of the excess skin is the reason for their abdominoplasty, and occasionally a rectus muscle tightening is not necessary. If we find any separation present and the patient is not planning future pregnancies then we will often perform a plication of the muscle gap. If a pregnancy is a possibility then avoiding a muscle repair is safer for the woman and her future pregnancy.  

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. You will know if you have abdominal wall laxity based on evaluating your abdominal wall on physical examination. For example, if you were to lie down and raise your head off the bed you may notice an abdominal wall "bulge" that may be secondary to spreading of the abdominal wall muscles. Ultimately best to seek consultation with board-certified plastic surgeons who can demonstrate significant experience achieving the types of outcomes you will be pleased with. You may find the attached link helpful to you as you learn more. Best wishes.

If you feel a separation between your six-pack muscles when you flex your abs and you have a concomitant bulge you most likely would benefit from a Rectus plication. Dr. Burnett

While vertical rectus muscle plication is not a requirement to be done during a tummy tuck, it is more times than not beneficial for the overall abdominal flattening effect. This can largely be determined before surgery and ultimately is the surgeon's call during surgery.

Most patients who undergo a tummy tuck are candidates for a rectus plication. Normally when women presents with a need for a tummy tuck all of the components of the abdominal wall have stretched out. This results in loose skin with stretch marks and widening of the area between the 2 rectus muscles. Very commonly a separation of the 2 muscles can be palpated preoperatively. Intraoperatively it is also easy to determine whether or not plication would be helpful. The addition of muscle plication does not appreciably increase the risk for the overall procedure.My simple and illustrated video may help you--learn more about tummy tucks and other body contouring procedures.