Is it possible to substantially tighten abdominal muscles that have very little, or even zero, diastasis? (photo)

I am age 66, 5'5", 118 lbs. Was always slim. Gained 25 lbs during pregnancy (2x) but easily returned to pre pregnancy weight with flat tummy, no loose skin, no stretch marks. Not much change until menopause. Now have aquired this awful distended gut! Doubt is visceral as it goes flat if lying on back or if 'sucked in'. Some sub-q fat gain on abdomen. Only separation I can find is one finger wide on lower abdomen. Will a full tummy tuck fix this?

Doctor Answers 7

Is it possible to tighten the abdominal muscles?

With pregnancy, as the uterus expands so does the abdominal wall. It's true that a daistasis can occur between the rectus muscles, but the muscles themselves can widen and become thin. Quite often we don't simply repair the diastasis, but rather plicate, or fold, and repair the rectus muscles themselves. This may well be case for you. You have done your homework and appear to be a good candidate for abdominoplasty. I would reommend you contact a board certified plastic surgeon in your area for a consultation.


Lexington Plastic Surgeon
4.1 out of 5 stars 11 reviews

Fascial tightening without diastasis

Your photos suggest that your assessment of the location of your fat in the abdomen is correct, that is, it is likely subcutaneous and not visceral. That is not to say that there is not a visceral component, but it is not the over-riding fullness. Given that, there should be room to do a significant snugging of the muscle fascia over the rectus abdominus (6-pack muscles).  That essentially lays the foundation for a satisfactory abdominoplasty, because when the overlying skin is then tightened, the abdominal wall will not be able to push it out as it has in the past.  See a board certified Plastic Surgeon to receive a thorough evaluation and discussion of your options and what to expect. I think you have the makings of a very nice result. I hope your experience is very good.

Jeffrey G. Copeland, MD
Saint Louis Plastic Surgeon
5.0 out of 5 stars 6 reviews

Dr Kayser

Thank you for your question. Based on your photographs and description, I believe you to be an excellent candidate for a tummy tuck. This is an outpatient procedure and Recovery is generally uneventful. I would certainly consult with a board certified plastic surgeon who is experienced in these matters. I hope this helps and have a wonderful day. Dr. Kayser - St Clair Shores/Detroit

Melek Kayser, MD
Detroit Plastic Surgeon
4.9 out of 5 stars 31 reviews

Tummy tuck

Hello and thanks for your photosYou appear to be a good candidate for abdominoplasty. Many women don't have much, if any, true diastasis, but still have laxity of the abdominal wall fascia. It's actually the fascial laxity that's the bigger problem in many women. The plication/tightening is done in the same way. In an abdomen like yours, it often makes a very nice improvement to do a full abdominoplasty with a bit of liposuction.Best wishes-

Tummy Tuck

Thank you for your question and photos. You appear to be a very good candidate for a full abdominoplasty with plication of the rectus abdominal muscles. I can tell you have done your homework by your terminology.  Truth is, the abdominal muscles can become lax even without a diastasis and thus, the tightening of the muscles, the internal work of the abdominoplasty, will certainly benefit you. Consult with a Board Certified Plastic Surgeon in your area to discuss all your options and expectations. I feel you can expect a very nice result!!Best Wishes,Michael Morrissey, MD

Is it possible to substantially tighten abdominal muscles that have very little, or even zero, diastasis?

Thank you for your question and series of photographs.  You can tighten the stomach muscle walls even without a frank diastasis and I think you would make an excellent full tummy tuck candidate to significantly flatten your abdomen and remove the excess skin your pictures demonstrate.  Be sure to see a board certified plastic surgeon in consultation.  

Nelson Castillo, MD
Atlanta Plastic Surgeon
5.0 out of 5 stars 43 reviews

Tummy tuck

Hello and thank you for your question.  Yes, fascia can be tightened even in this setting.   Based on your photograph, you are a great candidate for a tummy tuck with liposuction.  This can be done through a low and short incision, all completely below the bikini line.  Your muscles can also be plicated resulting in a flat abdomen. The most important aspect is to find a surgeon you are comfortable with. I recommend that you seek consultation with a qualified board-certified plastic surgeon who can evaluate you in person.

Best wishes and good luck.

Richard G. Reish, M.D.
Harvard-trained plastic surgeon

Richard G. Reish, MD
New York Plastic Surgeon
5.0 out of 5 stars 81 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.