Is a flat tummy achievable with a tummy tuck? Is there a difference between diastasis and muscle laxity? (Photos)

Question

I am trying to decide if a tummy tuck is what I need and if the muscle repair will help make me flat. My insurance has already approved me for a breast reduction as well!

Christopher Pannucci, MD, MS · Answer

Hi MMO Time,
The photos are particularly helpful--thanks for attaching them.
From the perspective of contour, you have excess lower abdominal skin and fat, and extra fat around the hips as well. Tummy tuck can treat both problems through a combination of direct excision and liposuction.
From the perspective of your abdominal wall, the "sucking in" vs. "relaxed" pictures show you have bulging. There are two common reasons for bulging, and both can occur concurrently. Reason 1: Some women have rectus diastasis--a right to left gap in the six pack muscles from stretching of the abdominal wall--this is potentially correctable with rectus muscle plication in tummy tuck. Reason 2: Some women hold their fat ("visceral fat") inside the abdomen next to their intestines, and this fat produces a rounded or bulgy upper abdomen. this is not correctable with tummy tuck.
I would suggest meeting with a board certified plastic surgeon to explore your options.
Hope this helps!
Best,Christopher Pannucci MDBoard Certified Plastic SurgeonPlastic Surgery NorthwestSpokane, Washington

Alan Gonzalez, MD, FACS · Answer

Hello @MMO TIME thank you for your question and showing your pictures. Yes, a flat tummy is achievable as long as it is performed with a total muscular plication. To answer the second question, yes, there is a difference. The diastasis is the separation of the muscles generally associated with pregnancy and large weight gain, while laxity is the muscle stiffness associated with genetic and dietary factors. I hope this helps shed some light. Best wishes! Alan Gonzalez MD, FACS.

Finny George, MD · Answer

Hi, thank you for sharing your question. You are a great candidate for tummy tuck with muscle repair and liposuction of the flanks and back. This will allow you to achieve the maximum result with regard to contour, flatness and shape.

Dhaval M. Patel, MD · Answer

Thank you for your questions and photos. From your photos, you are a good candidate for a tummy tuck with liposuction. A tummy tuck will address excess skin & repair of the abdominal muscle. The abdominal wall can be weakened after pregnancy and (or) significant weight gain & loss. By repairing the muscle, not only does the appearance of your abdominal area improve, but your core strength as well. The repair of the muscle will cinch your waist like an inner corset, which will accentuate your curves. Liposuction will remove excess fat from unwanted areas with some skin retraction. Your expectations and health will dictate the best procedure(s) for you. I suggest a consultation with a board certified plastic surgeon to go over the options that best address your goals. Best of luck!

Dhaval Patel MD
Double Board Certified Plastic Surgeon
Chicago
South Barrington
Oakbrook
Orland Park

Dhaval Patel MD 
Double Board Certified Plastic Surgeon 
Chicago 
South Barrington 
Oakbrook 
Orland Park

Gary M. Horndeski, MD · Answer

If you are not planning future pregnancies, I recommend abdominoplasty with mesh reinforcement. The mesh creates a more hourglass figure by compressing the abdominal wall resulting in early satiety and helps maintain a reduced weight.

Best Wishes,

Gary Horndeski, M.D.

Best Wishes,

Gary Horndeski, M.D.

Alexandrish Karvendrish Rodríguez Tavárez, MD · Answer

Hello! Hoping this answer can help you clarify your doubts. In your case, the abdominoplasty will make your abdomen looks flat, when the muscles have lost strength, which is common when there is abdominal diastasis, the repair of the rectus abdominal muscles tightens it and this will solve your problem. We are here to help you!

Carmina Cardenas, MD · Answer

You have an important  degree of saggy skin on your abdomen and also sides on abdomen so if you get just a regular TT you will end a up with dog ears, so I consider you are candidate for A bit Extended Tummy Tuck to prevent dog ears. 
Your muscle is extremely loose and will need a wide and tight muscle repair, my average is 4-5 inches but I have done 8 inches (20 cm) in patients with severe laxity. Also you are candidate for Mons pubic lift in order to rejuvenate the area and some liposuction to waist and lovehandles. 
Be encouraged!!! You will look awesome!!
Dr. Cárdenas

Daniel Barrett, MD · Answer

Dear MMO TIME,
based on your photos, you look like a good candidate for a TT. Full tummy tuck should tighten your abdominal muscles and remove the excess skin. Flanks liposuction would give you a better shape. I would suggest you to consult a board-certified plastic surgeon because only after a thorough examination you will get more information and recommendations.
Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Joseph Batac, MD · Answer

Good day and thank your for your question. After studying your photos, a tummy tuck would be an ideal procedure for you to achieve your goal of a flat abdomen. A diastasis is a separation between your two rectus muscle. The muscles themselves should meet at the midline of your abdominal area. If you have a separation of 2 fingerbreadths then a repair of this diastasis should be performed. With the repair completed it will definitely help you to get a flatter result. Good luck with the rest of your journey.
Cheers,Joseph Batac, M.D.Double board certified plastic surgeon

Edgar Torres, MD · Answer

Without the slightest doubt, a well-done TT, with emphasis on the plication (closure) of the abdominal aponeurosis (resistant tissue that covers the muscles) will make your abdomen flatten as much as possible, thus eliminating the diastasis recti that is the maximum level of muscle weakness or flaccidity to the extreme that implies a defect in your midline tissues. In other words, a compression garment is constructed like the one you wear when you want to flatter your figure by putting on certain clothes, but constructed of your own fabrics, permanently. In passing, the TT will remove the extra skin it has, its extra fat, and will release a very different navel, this time surrounded by skin without stretch marks.