I Have No Kids, Do I Need Muscle Repair? (photo)

This is the sort of thing that needs an in-person physical exam to determine.  While women who haven't had children or previous abdominal surgery are less likely to need a muscle repair,  sometimes we find there's some abdominal wall laxity at the time of surgery, and they can get a better shape if I do the plication sutures.

It is impossible to tell from photographs alone if a muscle repair is needed in your case.  Only an exam by your surgeon or a visualization in the operating room can tell for sure. That being said, if there is some separation in your muscles, a repair during your tummy tuck will help your final result significantly.

Hello. I would not recommend you having surgery if your BMI is above 30 because it can cause unnecessary risks and complications for an elective surgery. I can not make this calculation for you because I do not know your height. If or when your BMI is below 30 and you decide to get a tummy tuck done your muscles will be assessed during the surgery. Because you have had no children there is a good chance that you do not have much diastasis recti but it is impossible to know for sure pre op. If you have children after the tummy tuck you may need a revision in the future.


Jaime Perez, MD
Tummy Tuck Specialist
Plastic Surgery Center of Tampa

Thank you for your interesting question and photographs. There are a few issues that you need to address before surgery: 

1)  Usually, most 24 women, who have not had children, do not require abdominal muscle repair. See a Board Certified Plastic Surgeon who can determine whether you have abdominal muscle laxity or a hernia.

2) After some weight loss you may become a candidate for abdominal liposuction or abdominal liposuction with a mini tummy tuck. The mini tummy tuck can remove any excess lower abdominal skin, has a shorter scar, and an easier recovery than a full tummy tuck.

3)  I recommend that you lose some weight first by joining an inexpensive  proven healthy weight loss program such as Weight Watchers or Jennie Craig. They are effective at giving you guidelines and  eating plans to help reach your goal. 

4) Increasing your physical activity with walking, the gym, dancing, swimming etc., which will boost your metabolism and help you reach your ideal weight faster. Downsizing before surgery is the best option.

5) Your Body Mass Index (BMI) is elevated and should be between 25-30 before you have surgery to minimize complications and have the optimal long term results. You only need your height and weight (225 pounds) and you can easily calculate it by using a BMI chart found on line.

Don't be discouraged. I am sure you can accomplish your goals with a sensible plan. Best wishes.

There are several possibilities for you to think about when considering body contouring surgery.  You should be at an optimal weight and should not consider an abdominoplasty as a weight loss procedure.  It is not possible to determine whether or not you would benefit from a tightening of your anterior abdominal wall fascia.  There are no absolutes in plastic surgery and all surgical procedures are planned to give the patient a safe and reliable result.  You first need an assessment of the competency of your anterior abdominal wall laxity.  If you can push your abdomen out to a significant degree then you may want to consider repair of the fascia.  In many cases the fascia is not repaired and the patient has a skin only abdominoplasty with contouring liposuction of the flanks, posterior hips and upper back.  If your goal is to get rid of the overlapping skin and fat of the lower abdomen and to tighten the skin of the upper abdomen then you will do well with a skin only abdominoplasty.   If you have had a good deal of weight fluctuation, gaining 40 pounds then loosing 40 pounds then it is more likely than not that the fascia is going to be some what lax.  

Stetching and separation of abdominal muscles happens because of increased  intra abdominal pressure (due to pregnancy/ies or accumulation of extra fat in the abdominal cavity of overweight people). I also have observed thinnindg and separation of the abdominal muscles in males and indiduals who have "hanging" skin aprons putting stess on the abdominal wall. Most likely your surgeon will "tighten" your abdominal muscles whenever is the appropriate time to performe your tummy tuck operation.

I have never heard that one before!  If you have not had children, you may not have muscle laxity---or you could.  This could easily be ascertained in a physical exam.  You definitely need at least a panniculectomy and some liposuction but the only way to determine the extent of the surgery would be in a consultation.  If your weight is unstable, then it is reasonable and potentially worthwhile to try to reach a stable weight prior to surgery.

Simply going by your photos, your muscles are not the sole issue. There are three components when a plastic surgeon looks at a tummy: muscle, skin and fat. I recommend you losing weight to a weight you can realistically maintain. Then you should see a Board Certified Plastic Surgeon to access your fat, muscle laxity and amount of excess skin. If you're skin retracts, you may benefit from liposuction to contour you abdomen further. If your skin does not retract, a tummy tuck may be in order. Just keep in mind, you are very young and tummy tuck's come with a long incision. You may be better off waiting until after you have children and then revisiting the idea of surgery.

That can only be answered following an exam done as part of a consultation. It is not true that rapid weight gain is protective of the abdominal muscle wall. Think pregnancy, the commonest cause of muscle laxity leading  to tummy tuck surgery.

It looks like you should expect a nice outcome. While  getting ready to decide try to work down your weight. The procedure will be safer and will have a better outcome. Try for a BMI of 30 or less.

When you are ready for an in person consultation, RealSelf has listings of surgeons in your area. You should consider cross referencing the listings from the The American Society of Plastic Surgeons (plasticsurgery dot org). A listing in the ASPS website assures you that your surgeon is not only board certified,  but also is a member in good standing of the major plastic surgery organization in the U. S. Thank you for your question, best wishes.

 

Muscle repair or tightening is often an important part of a tummy tuck procedure.  The best assessment is with your consult and exam.  The key to a good result often lies in a balanced body weight with you height (BMI).  Remember that you also have fat inside your abdomen.  Weight/Height combinations for a BMI 25/26 or lower will usually signal a good place to start.  If you lose wight first, the inside fat decreases.  That allows the muscles to be made more snug and gives you a flatter tummy.  The excess skin and fat removal on the outside then completes the process.  I hope this information is helpful.