How do you know if you need muscle repair when you are getting a tummy tuck?

I had a c-section and have a pouch that I am thinking about getting rid of, but how do you know if you need muscle repair?

Doctor Answers 9

Tummytuck after C-section

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}
It sounds like tummy tuck his your best option if you are not planning on having more children at this time. The extra skin may be removed as well as revision of the C-section scar and the abdominal wall can be tightened to add to

New York Plastic Surgeon
5.0 out of 5 stars 33 reviews

Tummy tuck - when is a muscle repair needed?

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}
This seems a simple question, but it's a very good one, and is a part of every tummy tuck consultation.

There are three elements the surgeons considers when evaluating you for a tummy tuck:  The skin, the thickness and evenness of the fat layer under the skin, and the state of the abdominal wall.

Based on the evaluation, a surgical plan is made planning removing the skin excess if it is present, thinning out and making more even the fat layer, and repairing or strengthening the muscle layer if it is stretched and loose, or if there is a rectus diastasis, or gap, between the rectus muscles.

Basically, it is not usually necessary to do a muscle repair if there has not been a pregnancy.  There are exceptions to this after massive weight loss, but it is not common.

If there have been pregnancies, one of four situations occurs.
1. The muscle wall is firm, and there is no gap between the muscles.  In this case, no muscle repair is required.
2. There is no gap between the muscles, but the whole abdominal wall sheath is stretched, leading to a lower abdominal bulge.  In this case, an anterior sheath plication tightening is required.
3. There is a gap which can be detected between the muscles, but it is not large, the abdominal wall sheath is strong, and there is no bulge forward with activation on clinical exam.  In this case, usually no muscle repair is necessary.
4. There is a gap between the muscles, and on clinical exam a bulge on muscle activation is seen.  In this case a muscle repair is necessary.

The plan as to whether to repair the muscle or not is made during a cereful clinical exam by the surgeon.  The issue is not whether there is a gap, but whether ther is a bulge on muscle activation. Ultrasound, or other radiology examinations, are not very useful, as the bulge is usually seen on muscle activation, especially twisting or flexing. This can be diagnosed on clinical exam.

So, in summary, it is usually able to be determined in the preop assessment whether a muscle repair is going to be required.  It's important to have it planned, as if you don't need a muscle repair the operation is less painful and has a faster recovery. 

Where there is doubt whether the repair is needed, and there is in some cases, it is usually better to do it.

All the very best,

Howard Webster
Plastic Surgeon.

Muscle repair with tummy tuck

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

During an exam, your plastic surgeon can determine if your abdominal muscles are separated and if you could benefit from the repair.  Often women will have some degree of separation as a result of pregnancy. I recommend meeting with a board certified plastic surgeon who can not only give you an opinion based on your anatomy, but also provide you with detailed information about the procedure.

Camille Cash, MD
Houston Plastic Surgeon
4.9 out of 5 stars 36 reviews

You might also like...


{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}
An experienced plastic surgeon can exam your rectus muscles and determine your separation. Your lower pouch is likely muscle laxity if your height, weight are normal and you lead an active lifestyle.

William C. Rigano, MD
Dayton Plastic Surgeon

Muscle Repair and Tummy Tuck

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}
Typically the membrane that hold the "sit up" muscles together in the middle of the abdomen get stretched apart with pregnancy or weight gain and cause a protruding, bulging abdomen.  If your tummy is flat without "sucking in" your abdomen you don't need a muscle repair.

Sometimes skin hangs over a c-section scar and only the extra skin needs to be tightened (micro-mini abdominoplasty).

Discuss your situation and have an exam with a qualified, board certified plastic surgeon to find out for sure.

Deborah Ekstrom, MD
Worcester Plastic Surgeon
4.7 out of 5 stars 39 reviews

How do you know if you need muscle repair when you are getting a tummy tuck?

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}
This will depend upon your in person exam. He or she can evaluate for any degree of rectus diastasis (muscle spreading apart). Make sure you see a board certified plastic surgeon who takes the time to properly examine and evaluate you and recommend the best procedures for you! Good luck!

Muscle tightening with tummy tuck

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}
Muscle tightening is a typical component of most standard abdominoplasty procedures. Almost every patient who has had pregnancy or weight loss has some degree of abdominal wall muscle weakness or diastasis (spreading apart of the muscles).  Sometimes this is easily recognizable on the physical examination. Other times it is less noticeable.  Even patients with very minor muscle weakness will usually benefit from some degree of midline muscle tightening during the procedure.  Discuss these things with your plastic surgeon. Make sure you go to a board-certified plastic surgeon for your consultation.  

Erik Miles, MD, FACS
Charlotte Plastic Surgeon
5.0 out of 5 stars 35 reviews

How do you knowif you need muscle repair when you are getting a tummy tuck?

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}
A board certified plastic surgeon will be able to determine if you will need muscle repair with a physical exam. Go in for a consultation with a surgeon in your area to come you with the best treatment plan. In my practice in the San Francisco Bay Area I have come to the conclusion that the happiest patients are those with a good understanding of what a procedure will and won't do for them. Good luck. Dean Vistnes. 

M. Dean Vistnes, MD
Bay Area Plastic Surgeon
4.9 out of 5 stars 51 reviews

Muscle repair during tt?

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}
Good question. The way you will know is to go for a consultation with a board certified plastic surgeon. During the consultation, the surgeon will show you if you need it or not, and what the benefits would be. Usually after a c. section, there is more weakness in the muscle fascial layer. 

Rick Rosen, MD
Norwalk Plastic Surgeon
4.8 out of 5 stars 28 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.