5'6, 118lbs - can muscle repair in a TT over-loosen over a period of time? (Photos)

Rectus diastasis repair is a key component of a tummy tuck, but it is important to take the surrounding muscles into consideration. The traditional tummy tuck procedure repairs the muscle by closing the space and reconnecting the muscles. However, many patients with rectus diastasis have concurrent weakness of their abdominal muses. Therefore to avoid a post-surgical bulge of the lower abdomen, I have developed a holistic approach called "Functional Aesthetics." It is an evolution of the conventional tummy tuck and is designed to build a beautiful and toned core.

It appears you have had a good outcome from your surgery. If you are concerned that the small lower abdominal fullness may be a recurrent diastasis, you should schedule a follow up appointment with your surgeon. To make this diagnosis will require a physical examination.

Thanks for your questions and photos. Generally speaking, it looks as though you have a nice abdominoplasty result. Few plastic surgeons would be quick to reoperate on a mild bulge such as what you demonstrate. I have seen some improvement with the use of EMSculpt and EMSculpt Neo. You may want to try this noninvasive option. Best of luck.

It is difficult to make an assessment without seeing you in person. Having said that, there are a variety of reasons for a persistent lower abdominal bulge after surgery- one of them being rectus diastasis recurrence. The number of layers of plication (tightening), the type of suture used, and the amount of fascial tightening during surgery matter. Persistent laxity of the fascia from suture failure or inadequate fascial advancement is one reason for a lower abdominal bulge following abdominoplasty. This is not to say that this is the case in yours- and I think overall you have a very nice result- but I would recommend seeing a board certified plastic surgeon to evaluate you in person and see if this is the case.

Hi. It is certainly possible for a muscle repair to loosen or weaken over time, but it is something that I rarely see. Really hard to comment accurately in your case, though, not knowing the specific techniques that your surgeon used or what your physical exam is like. Sometimes the muscle repair is intact but the muscles just need to have dynamic strengthening with core exercises etc. I would recommend getting back in to see your surgeon for an examination and let your surgeon give you an assessment and options. Depending on how that goes you can always consider a second opinion if needed.
Good luck and take care, Dr. Howell

It depends on the technique used for the muscle repair, but they can break/fail with time. I would be curious to have the exact operative details of the operation--usually these are telling of why the muscle repair failed. There are other causes of recurrent muscle laxity, but based on your description of the timeline (and that you have been weight stable), it does sound possible in your case. In person examination is also very helpful to determine the cause.

Hi, It would be unusual for sutures to "break" and loosen the repair that many months following surgery. What is more likely is that the lining around the abdominal muscles, where the sutures are placed, may not be very robust and over time the constant pressure of the intestines can push on a repair and weaken it as the suture is pulled out of the lining. This is seen mostly in the upper abdomen no lower as in your case. You should be examined by a physician to ensure it is a weakness in the abdominal wall and not something else.

I'm trained to look at fraudulent before and after photos or my colleagues, a common phenomenon. The most common trick is not photoshop, it's changes to the lighting, camera position, and the subject's body/head position. These tricks are done with the intent to make the outcome look better. I'm not suggesting you did anything on purpose, but your first photo set clearly shows a straighter lumbar spinal curve (and a flatter tummy) in the before. The after shows a pouting belly, but along with a greater lumbar lordosis, indicating a significant relaxation of your abdominal wall. Keep in mind that people that have never had children or massive weight loss can do the same thing with their supposedly normal abdomens. At six months, where your belly looks flat, there should be no additional changes that would occur associated with the healing process other than reduction in swelling of your subcutaneous tissues. The only possible anatomic change that would have an effect on your abdominal contour is intra-abdominal fat deposition, which may or may not be a possibility.

Dear lindyshellp,
I understand your concern. However, without a proper assessment, it would be difficult to determine what went wrong. It is best that you visit your plastic surgeon for further assessment or ask for a second opinion. Only after a thorough examination, you can get proper recommendations and advice.
Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Thank you for sharing your question and photographs. Nothing replaces an in-person examination as swelling, fluid collection, recurrent muscle laxity, inappropriate muscle tightening, or failure of the muscle repair may be the cause. Based on your photographs I would be concerned that the muscle laxity has returned and will require surgery to correct.