How does a surgeon evaluate/know if you need muscle repair after having only 1 child & at 18 years old? (photos)

I had my son when I was 18 years old and gained over 55lbs going from about 115lbs to over 172lbs! I lost ALL the weight 2 years later (gradually and without working out) but I am left with excess skin and need a full tummy tuck done but how could I know or how does the surgeon know if I would need muscle tightening? I am 25 years, 5'1 and weigh 120lbs but expect to loose at least 5 more pounds with working out.

Doctor Answers 9

How to know if a muscle repair is necessary in a tummy tuck.

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}
The muscle repair is a bit of a misnomer. During pregnancy the two rectus muscles, (your six pack muscles) spread apart to accommodate the growing baby. After you give birth, the abdomen will contract, but sometimes a space is left between the muscles. We call this space a "diastasis." This space can lead to bulging above and below the belly button. The "muscle repair" is actually a diastasis repair where the inner edges of each muscle are brought closer together to prevent any bulges. Many of us check for this space by having you lie flat on your back while lifting your legs and head off the exam table. This tightens your rectus muscles and allows us to feel how wide this space is. Based on this exam, a determination is made as to whether you need the repair or not. Exercise and core strengthening can help with the diastasis but not with the predictability of surgery. Hope that helps!

Boca Raton Plastic Surgeon
5.0 out of 5 stars 26 reviews

Your contour

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}
Usually tells if you have a diastasis or need of muscular tightening. I will frequently have patients lie down to assess the amount of intraabdominal, or visceral, fat as well as the size of the gap between the muscles and any hernias that may be present. Good luck!

Eleanor J. Barone, MD
Tampa Plastic Surgeon


{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}
Thank you for the pictures.

Normally I am able to tell what procedure would be best for you by looking at the area that seems to be protruded, I can tell that our abdominal muscles need to be repaired.

Dr. Campos

Jaime Campos Leon, MD
Mexico Plastic Surgeon
4.4 out of 5 stars 257 reviews

Muscle tightening....

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}
Most women need at least some plication (muscle tightening) to restore abdominal wall integrity and keep the tummy flat. Based on the photos I would say you definitely could be helped with muscle tightening.



The need for tummy Tuck muscle repair is determined by your surgeons examination

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}
The muscle split after pregnancy is called a Diastasis Recti and is a separation of the 2 abdominal muscles caused by pregnancy.

Your plastic surgeon will ask you to tighten your abdominal muscles while the surgeon is feeling between the muscles during your physical examination. In most cases the split in the muscles and the need for muscle repair during tummy tuck is determined at the time of physical examination.

However in some cases the need for muscle repair does not become apparent until the tummy tuck surgery is performed

How does a surgeon evaluate/know if you need muscle repair after having only 1 child & at 18 years old?

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}
    The need for muscle repair becomes readily apparent after a physical exam.

Select a plastic surgeon who performs hundreds of tummy tucks each year and has great reviews and before and after pictures.

Kenneth Hughes, MD

Los Angeles, CA

The need for muscle repair

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}
Thank you for your pictures. Your surgeon's experience will guide him or her as to whether you have a diastases. His or her clinical examination directly of your abdomen and his/her visual appreciation of the abdomen will lead him or her to determine if muscle repair is needed.

Earl Stephenson Jr, M.D. DDS FACS

Rectus Diastasis

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}
From your photos it appears that your abdominal wall musculature and fascia have spread.  

For most most women who have gone through child birth, this spread, or rectus diastasis, indeed needs to be tightened.

To perform an abdominoplasty without tightening the abdominal muscle and fascia will often result in a poor contour and sometimes a large bulge above the umbilicus (belly button).

The vast majority of patients undergoing an abdominoplasty with a history of childbirth require (would benefit greatly) from fascial tightening (rectus plication).

Of course, patients should always see a board certified (ABPS) plastic surgeon for questions regarding abdominoplasty, or any other other body contouring procedure.

Joshua Lampert, MD,FACS
Miami Plastic Surgeon
5.0 out of 5 stars 27 reviews

How does a surgeon evaluate/know if you need muscle repair after having only 1 child & at 18 years old?

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}
Hi and thank you for posting your question. Congratulations on your baby. I am very happy to see that you almost lost all the weight that you gained during pregnancy. Pregnancy is really tough on a woman's body. It's really difficult to assess from the pictures if you have muscle separation. Having said that it's likely that you have rectus diastasis. I usually determine that during my physical exam. Nevertheless, I find that a lot of ladies have some degree of muscle separation that will repair anyway. The repair helps flatten the abdomen and enhance waist definition. I hope this helps you. Good luck!

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.