Correlation Between Extent of Muscle Separation and Recovery?

I was wondering if there is correlation between the recovery /pain and the amount to which muscles are seperated ? Also, does the amount of skin removed matter ? Have the drs correlated any variables ( time under general , etc)in the surgery vs recovery ?

Doctor Answers 8

Muscle separation and amount of skin to remove

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The pain with plication comes from the plication ,i.e the muscle tightening . A very large diastasis could lead to  more tightness afterward but the pain is from the suture line. So coughing , sneezing , laughing will cause discomfort and pain. So my answer is no with one caveat . A very large diastasis could have more pain if extensive surgery is needed instead of the routine plication. The amount of skin removed does not matter with pain .

The only variables correlated with time under anesthesia would be nausea from anesthesia and DVT's . Recovery is person specific and how they handle pain. The goal is to get up and moving ASAP to avoid fever, DVT's and to get you back to your normal life. 


Tampa Plastic Surgeon

Correlation Between Extent of Muscle Separation and Recovery?

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       In general, it does make sense intuitively that the greater the degree of plication the greater the discomfort for that individual.  Skin removal probably contributes less to the overall pain profile.  There is little to no research that has been published on these aspects.  Find a plastic surgeon with ELITE credentials who performs hundreds of tummy tuck procedures each year.  Then look at the plastic surgeon's website before and after photo galleries to get a sense of who can deliver the results.

Kenneth Hughes, MD Los Angeles, CA

Muscle repair with tummy tuck and recovery

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Almost all women who are candidates for a tummy tuck have significant abdominal wall and muscle weakness, which requires muscle repair. Obviously, repair of the muscle and removal of excess skin contribute to post-op pain, but there is adequate post-op pain medications that can make the procdure tolerable and successful.

Sean Younai, MD, FACS
Beverly Hills Plastic Surgeon
4.3 out of 5 stars 51 reviews

Correlation Between Extent of Muscle Separation and Recovery?

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There is no direct correlation between the "extent" of muscle separation and recovery. I have found ( anecdotally) is a patients who are physically, emotionally, psychosocially “fit” tend to do better with operations than patients who do not fit this description. In other words, patients who are positive and “glass half full” tend to have easier recoveries.  Regardless, these operations can  associated with physically and emotionally challenging recovery periods.  I have attached some advice I give my patients who are about to undergo tummy tuck or mommy makeover surgery:

1. Make sure you are doing the procedure for the right reasons (for yourself)  and that you have realistic expectations.  Be aware that an improvement in the “problem area” may not translate to an overall improvement in your life   situation.  You are bound to be disappointed with results of the procedure if your motivation for doing the surgery is not internally driven.

2. Time your surgery carefully; generally, it is not a good idea to have surgery done during or immediately after a stressful period in life (for example divorce or death of a loved one). The additional stress of surgery will undoubtedly be  more challenging to deal with if a patient's emotional reserves our already exhausted. Remember, that an improvement in your physical appearance will not translate to an improvement in your life situation.

3. If possible speak to patients who have undergone similar procedures and query them about the toughest times of their recovery period. Any practical hints previous patients can provide may be very helpful.

4. Make sure you are aware of potential complications that may arise how to reach your surgeon if necessary.

5. Make sure you have a strong and patient support system (several people if possible) in place who have time/patience to take care of you. Arrange for professional nursing if any doubt exists regarding the availability and/or stamina  of your caretakers.

6. Be patient with the healing process, understanding that it will take several weeks to months to feel “normal” again. It may also take many months/year to see the end results of your surgery.

7. Be prepared to distract your mind with things of interest such as books, magazines, and movies.

8. Expect less of yourself; do not go back to work, school or chores too early and let others take care of you (for a change).

9. Pick your surgeon carefully (a well experienced board-certified plastic surgeon) and trust in his/her advice. Keep in close communication with your surgeon and do not hesitate to communicate questions/concerns and the   emotional swings that you may experience.

10. Resume all medications that you were using preoperatively when cleared by your plastic surgeon and stop the use of narcotics and sedatives as soon as feasible after surgery.

11. Keep in mind the end results as you go through the tougher emotional times after your surgery.
I hope this helps.


More muscle separation might mean more recovery

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There is no way to know for certain, though as a rule the more support and repair to the muscle the longer the recovery after TT. Also for the few that need no muscle repair, we would expect an easier go of it after TT.

Peter E. Johnson, MD
Chicago Plastic Surgeon
4.0 out of 5 stars 44 reviews

More work = more discomfort

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It's of course patient dependent, but the more work that's done = more discomfort. Long acting pain injections and pain pumps do help.

good luck 

David Shifrin, MD
Chicago Plastic Surgeon
5.0 out of 5 stars 178 reviews

How Does the Tummy Tuck Belt Differ from the Bodylift?

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The one factor that makes recovery easier is the occasional patient that needs no muscle repair. Otherwise, the patients' individual response seems to have more variability than other factors, as amount removed, time in OR, etc. 

Long acting local anesthetics can help (pain pumps with Marcaine, or injections with Exparel). 

Discuss with your surgeon. All the best. 

Jourdan Gottlieb, MD
Seattle Plastic Surgeon

Muscle separation extent and recovery

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Thank you for your question, while there aren't any studies to look at the specific question, anecdotally the most painful portion of an abdominoplasty procedure is the muscular work and the more extensive this portion is theoretically there is an increased period of pain and recovery. I have found dramatic decrease in pain with patients undergoing abdominoplasty in whom I have used a very long-lasting local anesthetic called Exparel. 

Kevin Tehrani, MD, FACS
New York Plastic Surgeon
4.7 out of 5 stars 112 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.