Tummy tuck 7 months PO, age 45, how do I know my surgeon tightened my abdominal wall? (Photos)

Tigthening of the abdominal fascia is done only when it is clinically necessary (muscle separation) not in all abdominoplasty patients. After abdominoplasty, with or without fascia plication, tone of the abdominal wall will depend on muscle dynamics and strenght rather then fascial plication. Hope this may help.

Thank you for your question.
There is generally no way to check if your rectus muscles were tightened just visually. You can certainly ask for the operative report which will mention if the rectus muscles were repaired. I recommend speaking with your plastic surgeon to voice your concerns.

Hi Santana. I'm sorry to hear about your experience. Only your surgeon and his/her team could really answer this question. Perhaps, you could request the operative report that will specify in detail what was done during surgery. Sharing some of your before pictures could help. Imaging of your abdomen can also provide an answer. When choosing a surgeon, it's important to meet in person to obtain a full evaluation and discuss the proposed procedure. Virtual consultations are also available but your surgeon most likely will meet you before the procedure. Thank you for sharing.

Dear Santana8801,
I understand your concern. However, without a proper assessment, it would be difficult to determine what went wrong. It is best that you visit your plastic surgeon for further assessment or ask for a second opinion. Only after a thorough examination, you can get proper recommendations and advice.
Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Your photos appear as muscle plication was done? But you can request ultrasound examination ot MRI examination of the superficial anatomy looking for recti muscle separation. There will be fees to preform either or both tests.

I encourage you to speak again with your surgeon. It is important that you feel comfortable and confident in your recovery. You can also request a copy of your operative report from the facility where the tummy tuck was performed. It will contain in detail what was performed during your operation.

No one can tell if your surgeon plicated your abdominal muscles or not. Pre-op photos and better post-op photos would help us to compare.
You may request a copy of your operative report. It should specify if the rectus fascia was tightened.
These are some concerns seen in plastic surgery tourism (traveling outside your area for plastic surgery). Not uncommon to meet your surgeon at the time of the procedure, then never again.
Best wishes.
Dr. Taranow

Surgery schedules change all the time. Patients need to be flexible on the day of surgery because procedures get delayed all the time. If anything it signifies that your surgeon is willing to take the time it needs because he did for the patient before you just like he most likely would for you as well.
I wouldn’t worry that the surgeon didn’t do part of the procedure because your surgery was delayed by an hour. The two are totally unrelated.To assess the outcome of a surgical procedure patients and need to post before and after pictures. If you don’t have proper before and after pictures and then ask your surgeon to forward the ones they took.
Before pictures tells us a lot of information we need to assess the outcome of the procedure. The number one reason for someone having a bulging abdominal wall after a tummy tuck is the presence of excess visceral fat which should have been checked for during the consultation and may be able to be seen on preop pictures.
The best way to improve the outcome as weight loss.
There’s no way for us to assess how aggressively the muscle tightening was done but if your operation hurt afterwards you definitely had muscle tightening. Without muscle tightening there is virtually no pain afterwards and with muscle tightening the recovery is pretty intense.
Most people never question if they had muscle tightening because they feel it every day after surgery.
I it’s unfortunate your doctor is not willing to address your concerns. Consider writing a formal piece of communication letting him know you’re not happy with the way the postop visit went. Consider an old fashion letter in the mail and schedule a follow up after that.
Surgeons come in all different types and collars and plastic surgeons are notorious bunch for having big egos and not having the best social grace unless they’re trying to sell.
It’s also a stressful difficult job and sometimes an outcome can simply be less than the patient had hoped for and the procedure was done perfectly well. The surgeon knows it but the patient doesn’t.
Eye surgeons we see patients who have mediocre outcomes and are thrilled with the results and patients who have some of the very best outcomes and are never happy.
We learn to put up with the personalities and try to get through the day to get home with our families just to do it again the next day.
If you want a proper second opinion consultation then schedule those as in person consultations with other local board-certified plastic surgeons. For second opinion consultations you should come prepared with proper before and after pictures and a copy of your operative report. Simply requesting a copy of your medical records including your operative report will let your surgeons office know that they have a patient who is seeking a second opinion. That by itself should get him a little jumpy and start paying attention.
Most plastic surgeons are cognizant of social media and want to be careful that patients aren’t leaving upset because of potential negative consequence with bad reviews.
It’s OK to mention that you engage in social media, that you are an active reviewer but be careful to not come acrosss as using reviews as leverage or threat.
Instead of using words like “I was hoping to write a five star review and was excited about the outcome but their results are less than what I had hoped for. Can we review the before and after pictures again that you showed me?”
To assess your abdominal wall you can make a virtual B line between your sternum and your pubic bone.
In the upright standing position your muscle wall should follow that line. To feel your muscle wall take one finger and gently Press it against the skin until you feel the muscle while underneath. It does not take much pressure at all. you can compare that to the position of your sternum in relationship to be a big bone and see if your muscle wall falls right in the middle in a true vertical line.
If it’s bulging then press against your abdomen until the muscle wall is truly flat. if that takes a bit of pressure then visceral fat is the culprit which is pushing against the backside of the muscle wall causing at the bulge.
Another way to test for this is to see if there’s a significant difference in The shape of your abdominal wall laying on your back. you may need to have someone else take pictures or use the timer on your camera.
In the end your surgeon is responsible for the outcome of the procedure and you intern I responsible for choosing that surgeon.
Your pictures are a bit limited and like I said earlier it’s always better if you show proper before and after pictures the ones taken by your surgeon. Try to use the timer on your camera or have someone else take the picture from about 8 feet away showing the entire torso including the scar. keep your arms down by your side and stand in a neutral position showing pictures from the front, side and behind.
To me your results looks like a very typical quality tummy tuck result. I see nothing wrong with it but the result is always based in part on an individuals candidacy..
Best,
Mats Hagstrom MD