Should I Go for a Muscle Tightening with my TT Op? (photo)

I am a 34 yr old single mom who is now ready to date. Opting for a TT as I am v conscious of d stretch marks on my abdomen, loose skin & uneven surface after a lipo last year. My doc is suggesting muscle tightening. I, however, am a bit hesitant b'coz 1) It is more invasive & requires longer healing time. 2) I cannot rule out the possibility of getting pregnant again but only after 5-6 years IF I am in a committed relationship. But I cannot put off TT till then. What would you suggest?

Doctor Answers 12

Muscle Tightening

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

You definnetly      need   a  reintervention,     the  must  imporant is  the  time   you had  your  lipo ,   because    you    need   at  least      6 months to  one  year   to   let    tissues     recover    from  the injury  of your  first   surgery . It looks   to me    that    since    the  beggining    you needed  an  abdominoplasty     but  maybe    because   you  did not want   scars   you went    into    this   wich is a    result   of  an  inadecuate  surgical   procedure . The  only  procedure    that is going  to return a  better  and nice   shape  of your  belly is   the TT  combined   with a  liposuction   of   regularitation of the contour of  your skin ,   of    course  the   fascia  repair   (treatment over the  muscle) has to  be  perfomr    in  all abdominoplasty  procedure .   In conclusion  after   6  months   to  one  year    of  the  date of   your  lipo ,  my  recomendation   is to choose  a  good  plastic  surgeon     to  perfom   the  Abdominoplasty   ,  TT (with treatment of  muscle fascia) , combined   with   liposuction  wiht    specials   canulas   to  treat  the  iregularities   of  your  skin

Dominican Republic Plastic Surgeon

Perfect candidate

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

Hello Based upon your photos and information, your are a perfect candidate for a full Tummy Tuck and definitely a muscle repair that will help to achieve a flatter abdomen and a great impact on your waist line. The recovery is not very different with or without the MR. What makes the recovery tougher is the combination of procedures , but it will worth to have the TT, MR and some liposuction to sculp your body all in one procedure. The important thing will be in perfect conditions (blood work, EKG) and prepare your body prior surgery (healthy meals, lots of water, exercise, avoid alcohol and smoking) in order to prevent complications and have a better recovery. Good luck with your journey. Dr. Carmina Cardenas

Muscle Tightening with Tummy Tuck

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

A tummy tuck is a procedure to improve the cosmetic appearance of the abdomen when there is too much skin. What exactly is done depends on the precise anatomy of the individual person undergoing the procedure. For someone with as much loose skin as you, it is inconceviable that you will not require muscle tightening. If so, doing the tummy tuck without tightening the muscle is like doing a breast augmentation and forgetting to put the implant in. Adding the muscle tightening should only minimally increase your recovery or risks. I, personally, would not offer an option, as I see no reason to deal only with the skin when the muscle is partially responsible for the problem. I hope you are having the abdominoplasty by someone other than the person who did the liposuction, as your result should have been totally predictable and you need someone who understands and can predict what tissues do and don't do in order to get an optimal result.

Robert T. Buchanan, MD
Highlands Plastic Surgeon

Muscle tightening or just skin excision

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

If you tighten your stomach muscles as much as possible, and you still feel like your stomach isn't flat enough, you should do the muscle tightening now. You will be able to have a successful pregnancy in the future either way.
The recovery for a skin only tummy tuck is a bit easier, and there will be fewer restrictions on lifting and other activities after surgery. It's your decision if the added recovery and any potential extra costs will be worth it. Best wishes.

Tummy Tuck and Rectus Muscle Plication?

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

I would recommend that  when you undergo tummy tuck surgery, you have any separation of the rectus muscles plicated.  Doing so will undoubtedly improve the outcome of the procedure performed.  As you know, these muscles have spread apart during pregnancy and/or weight gain. Bringing them together again in the midline helps to “tighten” the abdominal wall as well as to narrow the waistline. 

 Re approximation of the rectus muscles in the midline will not necessarily interfere with future pregnancies.  Either way, additional surgery may be necessary after future pregnancies.

 In my opinion, if there is significant muscle separation, this is an easy decision.

 Best wishes.

Decision for muscle tightening is many times a personal preference

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

Because tummy tuck can be performed with or without muscle tightening at the discretion of you and your surgeon, much of this decision relies on your preferences.  It can sometimes be a complicated decision-making process, and as you have already alluded to, it may even take into account things that have not yet or may never happen, such as future pregnancy.  So it can be a real judgment call.  In the vast majority of instances, the muscle laxity is mostly an issue of aesthetic concern, thus, if you don't think the bulging of your tummy is too bad, and you feel as though your muscle tone is pretty good, it could make sense to forego the muscle plication and just have excess skin and fat removed.  Certainly if you really think that another pregnancy is in the cards for you, it makes sense to do without the muscle tightening.  It certainly wouldn't hurt you or your new baby if you did get pregnant again after tummy tuck with muscle tightening, as the tissues would accommodate.  It's just that they may stretch back out; I have seen it both ways, where it has recoiled back to good form after subsequent pregnancy, but also where it has not and the tummy remained loose again.  If you go into this knowing 1) your result will not be as dramatic if the muscle is not tightened and you are OK with that, and 2) you may wish to undergo a second tummy procedure in the future, and you are OK with that, then it may make sense to you to simply have the skin and fat addressed and leave the muscle alone at this time for the reasons that you mention.  Judging from your images, I expect that you would get a very big improvement from that alone.  If on the other hand you know that you do not want to have the possibility of another procedure in the future, and you want the most thorough and comprehensive job done now, you should go ahead and have the muscle done now while the surgeon is staring right at it, and whatever happens in the future with regard to further family planning, happens.  I would suggest having a frank and open discussion with your surgeon about all of these issues and bring to his attention your concerns.  He should be willing to work with you and your preferences or explain why it's not feasible to do that.  If he can't, get another opinion.  Good luck.

Joseph L. Grzeskiewicz, MD
San Diego Plastic Surgeon

Most women after pregnancy benefit from fascial tightening at the time of abdominoplasty.

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

One of the advantages of an abdominoplasty is the ability to address multiple problems creating abdominal wall protuberance. After pregnancy almost all women benefit from at least some muscle tightening.

Should I Go for a Muscle Tightening with my TT Op?

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

Yes I agree with skin only tummy tuck no muscle repair. But you need to discuss this IN PERSON with your chosen PS 

To muscle repair or not to muscle repair in a TT

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

A decision regarding muscle repair depends mainly on the functional state of your muscles.

An assessment of muscle function depends on physical examination, you can't really tell in photographs.

However, at a guess I'd say you are a candidate for a muscle tightening.

Douglas McManamny, MBBS, FRACS
Melbourne Plastic Surgeon

Regular abdominoplasty vs skin only abdominoplasty

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

With any body contouring procedures there are options and you could certainly consider a skin only abdominoplasty.  From your photographs it is not possible to assess the degree of laxity of your anterior abdominal wall.  If you have a significant laxity then you would definitely get a better long term result with a fascial repair.  Your plastic surgeon, at the time of a physical examination is certainly in the best position to understand your anatomy and make appropriate recommendations.  In either case an additional pregnancy or a large weight gain may cause a recurrence.   

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.