I'm Having an Extended TT, Do I Need Muscle Repair with One Cm Seperation?

i am having an extended tummy tuck in about 8 weeks, i have a 1/2" separation of rectus muscle (at 3 1/2 years post pregnancy) do i need a muscle repair? Would it make a big difference to the end result if i don't get or need a repair Also wondering i have a very sway back i have read that the repair assist in correcting this, and reduces lumbar pain, will it make as much of an improvement in sway and pain if a repair isn't done/needed

Doctor Answers 5

Do you need to have a muscle repair with a tummy tuck?

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Thank you for this question.

With childbearing the rectus abdoninus muscles, the washboard muscles of the abdomen, tends to move towards the side. The area between the muscles separates and this is called diastasis rectus. Even with diet and exercise the muscles to not return to their normal position after childbearing.

In a standard tummy tuck two components of the abdominal wall are addressed. One portion of the surgery involves bringing the muscles back together in the midline and closing the diastasis.  The second involves removing the loose and redundant skin.

Tightening of the abdominal muscles will generally flatten the abdomen.  This can depend upon how heavy the patient is.  More slender patients tend to stay flatter long-term.

You do not have to perform the  tightening if you don't want to.  You will still be able to remove the same amount of skin, you just won't be flattening the abdominal wall.

In my own practice I call this a non muscle tightening tummy tuck.  I turn to the non muscle tightening tummy tuck in people who do not have significant diastasis, people who are looking for a shorter or easier recovery, or people who are too heavy or not healthy enough to tolerate the muscle tightening.  It is generally the muscle tightening tht causes the majority of discomfort after surgery.  Even so most of my young and healthy postpartum patients usually want the flattest abdomen that they can have postoperatively.

You should discuss your goals with your plastic surgeon and ask for his or her opinion as to whether or not muscle tightening would be of benefit to you. Even though you seem to have a narrow separation I have never seen a postpartum patient that could not benefit from some degree of abdominal wall tightening.

I know that some people feel that muscle tightening can improve back pain.  I wish that I could prove this but I don't think it's quite clear at present. There are multiple causes of back pain.  In fact most of my patients who undergo full tummy tuck see a worsening of their back pain for a few weeks after surgery because the tight abdomen keeps them bent over until the skin relaxes.

Good luck with your upcoming surgery.




Washington DC Plastic Surgeon
5.0 out of 5 stars 115 reviews

Yes, you will likely benefit from muscle tightening as part of your tummy tuck

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Yes, you will likely benefit from the muscle tightening at the same time as the tummy tuck.  Best of luck.

J. Jason Wendel, MD, FACS
Nashville Plastic Surgeon
5.0 out of 5 stars 221 reviews

Tummy tuck and muscle repair

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Having a tummy tuck without a muscle tightening is like buying a car without the engine.   So all joking aside, yes, I would recommend muscle tighten (plication) with your extended tummy tuck.

Best of luck.

Dr. Basu

Tummy tuck and back pain

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When you're getting your tummy tuck, I would recommend getting the muscles tightened as well since it will help give you the best tummy tuck results possible.  However, be careful in thinking that your back pain will be helped with a tummy tuck.  In my experience, some people do, in fact, get relief from their back pain after a tummy tuck, but some people do not.  Also, insurance will not cover a tummy tuck to treat back pain.

Tummy tuck: when to repair the muscle

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The muscles should be repaired when it will make a significant difference in the final result and weighed against the downside of a slightly longer surgery time, more discomfort, higher risk of deep venous thrombosis(blood clots) and a longer recovery time. So if your main problem is that the muscle layer is stretched out then the muscle layer should be repaired. When the problem is excess sin and fat and there is little muscle looseness then the patient and the surgeon need to jointly determine what the muscle repair will add to the final result.

One way that you can tell is to stand sideways looking in the mirror and relax you belly muscles. If there is a significant bulging of your belly then you would benefit from the repair. If the difference is minor then you need to consider the downsides of doing a muscle repair. The 1 cm figure really doesn't have much meaning since we don't know visually what that means in your overall look.

John P. Stratis, MD
Harrisburg Plastic Surgeon
4.5 out of 5 stars 37 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.