What would be the reasons a PS would not tighten muscles during abdominoplasty?

I lost over a 125. I hd a tummy tuck two weeks ago. The PS said she did not tighten my muscles. Now 3 weeks post -op, if I tighten my muscles on my own I can see a noted improvement.

Doctor Answers 8

No muscle tightening during TT??

The most common reason to leave the muscles alone during TT surgery in women is for those younger patients who have not finished having children yet, but still have a lot of skin laxity.  This is fairly uncommon in my practice.

Unfortunately, this skin-only operation may compromise the ultimate result, as tightening both muscle and skin gives a superior result to just tightening skin only.

Orlando Plastic Surgeon
4.9 out of 5 stars 80 reviews

Muscle Tightening and TT

Hi and thanks for the question. The reason to not tighten muscles during TT is if there is no separation (i.e. Rectus Diastasis). The space between the muscles can be assessed in surgery and if there is no separation then muscle repair is not necessary. Best of Luck - Dr Hardy...

James E. Hardy, MD
Jacksonville Plastic Surgeon
4.6 out of 5 stars 57 reviews

Tummy tuck without muscle tightening.

Thank you for your question. Muscle tightening is typically not performed if the abdominoplasty is really a panniculectomy. After a significant weight loss, insurance MAY agree to a procedure to remove the loose skin that may overhang the abdomen. This is a panniculectomy. Insurance does not pay for tightening of the muscle or resighting of the belly button as in a standard cosmetic abdominoplasty or tummy tuck. I know this sounds strange but, that's the insurance business. The tightening of the muscles and the re sighting of the belly button are considered cosmetic and insurance will not pay for it. Continued success in your recovery,

J. Michael Morrissey, MD
Dallas Plastic Surgeon
4.9 out of 5 stars 17 reviews

No muscle repair

Hello,  thank you for your question.   Two things may had occurred: 1) Your PS thought you didn't need the muscle repair,  2)After your PS did the muscle repair you had some variations on your oxygen saturation and the PS decided not to do the muscle repair.  It's unusual that these things happen,  almost all TT need the muscle repair.  Have a great day. 

Derby Sang Caputo, MD
Dominican Republic Plastic Surgeon
5.0 out of 5 stars 84 reviews

What would be the reasons a PS would not tighten muscles during abdominoplasty?

Thank you for your question. May be your plastic surgeon did not think enough separation. Please ask hi when you see next time. You can improve the tone of your muscles with exercise.

Ven Erella, MD
Austin Plastic Surgeon
4.9 out of 5 stars 32 reviews

What would be the reasons a PS wound not tighten muscles during abdominoplasty?

Thank you for your question and I am sorry that your results have not been what you anticipated.  In nearly all cases of a tummy tuck patients benefit from a muscle tightening procedure to aid in the overall outcome, and it would be best to ask your surgeon why this step was omitted.  With a 125 pound weight loss did you perhaps have a panniculectomy and not a true abdominoplasty?  In the former the skin and fat is excised but the muscles are not tightened as in a tummy tuck.

Nelson Castillo, MD
Atlanta Plastic Surgeon
4.9 out of 5 stars 68 reviews

Muscles can be tight

Your plastic surgeon may have noticed that there was no muscle separation (diastasis recti) to be repaired or tightened.  Ask about this.  And yes, exercises can also help tighten your abdomen.
Best wishes, Dr. Denkler

Keith Denkler, MD
Marin Plastic Surgeon
5.0 out of 5 stars 19 reviews

Tighten muscles during abdominoplasty?

I'm sorry to hear about your concerns after tummy tuck surgery.  Only your plastic surgeon, will be able to provide you with a non speculative response. Generally speaking, the vast majority of patients who have had children and/or weight gain/loss benefit from muscle plication during tummy tuck surgery. Muscle laxity is usually easy easily determined with physical examination prior to surgery. The separation is also easily visualized during surgery.  IN MY OPINION, omitting this part of the procedure for the vast majority of patients who present for consultation will  likely leave them with continued abdominal wall laxity and, in my opinion, a less than optimal result. Best wishes.

Tom J. Pousti, MD, FACS
San Diego Plastic Surgeon
5.0 out of 5 stars 1,499 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.