With the Lockwood Procedure, How Are the Muscles Tightened Properly with Such a Small Seperation of Skin?

I was lucky enough to observe some of Dr Lockwood's operations and attend his seminars before he passed away.  here really is no Lockwood "procedure."  He simply outlined some principles that made sense for lifting and tightening the trunk and legs.  Some (in the case of inner thigh lift) turned out to not be the best option.

During tummy tuck, the skin was undermined or loosened to the level of the ribs the same as usual.  He was more cautious here, but he did go all the way up.  So muscle repair was done the same as in regular TT.

The big revolution was using the deeper tissues (not skin) to hold the tuck together, resulting in abetter scar in most cases.  Also, he believed that tension on the sides of the abdomen was more effective than in the center.  This does not necessarily mean a shorter scar....remember, he pioneered the lower body lift...which is a scar all the way around !

The late Dr. Ted Lockwood of Kansas City was an Anatomist ans a surgical visionary who single handedly revolutionized Tummy Tuck surgery and weight loss restoration surgery. He made many contributions to our profession and myself and many others regard him in extreme high esteem.

Among his innovations, besides describing the SFS layer which can readily pull the thighs up, he introduced the Lockwood dissector, a tool intended to allow skin undermining without dividing most of the blood vessels to the skin.

In his operation, which I perform very commonly, the transverse groin scar is NOT shorter but the tummy tuck is done with an aggressive plication (putting together) of the tummy muscles and careful undermining of the sides to preserve the blood flow to the sides of the upper tummy skin. The operation flattens the tummy, narrows the waist, lifts the thighs and a sagging Mons pubis.

Dr. P. Aldea

I believe you are referring to a limited undermining technique in tummy tuck surgery.  The main advantage of this technique is to allow the surgeon to perform some liposuction of the upper abdominal area at the time of surgery (which with normal tummy tuck techniques is not advised).  But to answer your question, yes it is possible to see the muscle and to perform the midline muscle repair with this technique.  It's a bit more difficult, but in skilled hands, works very well.  I suggest you go in for a consultation for tummy tuck surgery with a board-certified surgeon who is well-versed in this procedure.  Good luck!