One of the many jobs of a plastic surgeon is to first talk to the patient about what bothers them about their appearance then discuss the realistic goals and wishes of the patient. Involved in this process during the consultation is a physical exam. Based on all of this plastic surgeon then explains to the patient the actual process of the procedure and what steps are entailed in it. Many times during an abdominoplasty many women who have children or have lost weight have looseness of the abdominal wall. This contributes to the outward appearance or convexity of the abdomen from the side view. The muscle tightening is what flattens the abdomen. The removal of the excess skin and liposuction improves this but in certain patients if the muscle is not tightened then the final result may not be optimal. As long as you understand that if your situation involves muscle tightening to give you the best shape possible and you do not want to have the muscles tightened, then your final result may not be as optimal as it could be. It is best to be seen by a board certified plastic surgeon who performs many body procedures to give you the best result. Ultimately the decision is up to you regarding the muscle tightening, and the surgeon must take into account your wishes. It is then up to the surgeon if he or she wants to operate on you. That final decision to operate on you is ultimately up to the surgeon.
Dr. Ravi Somayazula
A consultation is a two way street and your plastic surgeon has listened to your desires, examined your body, and provided his advice. His recommendations may not be what you want to hear, but if you wish for an operation to be done another way, you can certainly continue your conversation with him; or you can seek another consultation.
I hope that this helps you to proceed.
It is possible for your surgeon to not do something that you don’t want, but you should understand that you will most likely not get the results you want in doing so. Muscle repair flattens bulging, and if you don’t get it but need it, your stomach will continue to bulge after your surgery. If you understand the implications, you should gently but firmly discuss these with your surgeon and I’m sure both of you will be able to reach an understanding.
A tummy tuck has basically two components, one is to remove extra skin and give the smoothest appearance possible, the other is to reduce the waist size by tightening the loose fascia. Most docs do not cut or sew muscles. A more experienced board certified ASAPS plastic surgeon may give you a result with a quick recovery. there is no guarantee, all surgery has risks...
If your plastic surgeon is recommending a muscle repair during a tummy tuck, that is likely because the surgeon feels it will give you a better outcome. If you do not want the muscle repair you do not have to do it. Just be aware that your result may not be as good. If you are seeking the advice of a professional (doctor, lawyer, etc.) I would listen carefully, that is why you are seeking their expertise. Whether you follow through with their recommendations, is up to you.
You are certainly free and actually encouraged to discuss exactly what you would like to accomplish with your surgery and what you would and would not like to see happen. That is the best way for you and your surgeon to be on the same page regarding your procedure. Having said that, if you're going to see a plastic surgeon certified by the American Board of Plastic Surgery, you're going to see someone who is well trained, has years of experience in the procedures you're interested in, is an expert in accomplishing those goals and wants you to get the best result possible. It is in your best interest to listen to his/her recommendations carefully and consider them.
Sometimes adjustments can be made to a procedure to accommodate certain circumstances but more often doing less will accomplish less and ultimately your goals may not be achieved. In some circumstances such changes may make it impossible to achieve a result that even warrants the risks associated with the procedure. In those situations it is important that your surgeon clearly explains this to you. It thus better not to have the procedure performed than have a poor or inadequate result while experiencing the same risks and costs. A reputable surgeon may very well refuse to perform the surgery if he/she feels that the expectations cannot be met. Again the surgeon is looking out for your best interests. Remember that cosmetic surgery is not only elective but also technically unnecessary. To take a risk without the chance of achieving the desired result or even a poor result would be unethical.
For the best results seek the consultation of a plastic
surgeon certified by the American Board of Plastic Surgery. They have a website
listing all the certified plastic surgeons. Members of the American Society of
Aesthetic Plastic Surgery will all be board certified in plastic surgery and
have demonstrated an interest and special skill in cosmetic plastic surgery as
For additional information about tummy tucks please see the web link below.
You bring up a couple of separate issues. One, you can certainly request a tummy tuck without muscle repair, especially if you have good muscle tone. Most surgeons will happily honor that request unless you have really lax muscle tone causing diastasis.
The second issue you bring up is the length of the tummy tuck incision. If your body shape dictates that you need a long incision tummy tuck and you do not want this, your surgeon may decide that you are not a good candidate for the shorter incision and refuse to operate on you because he/she knows that you will not get a good result. No surgeon should do a procedure that will not produce an adequate improvement or that will be potentially harmful to a patient. While doing a short incision tummy tuck will not harm you, you will certainly not get a good result if you really need a full or extended tummy tuck.
Platic surgeons develop a reputation based on their ethics and quality of their work. We train for many years to be able to do what we do and are being sought out and paid for our skills and knowledge.
While you are free to disagree with the suggested treatment and go to someone else, you cannot force a surgeon to perform an operation he knows would produce a substandard result. If you do not like what you hear, especially if you hear it repeatedly, you owe to yourself to listen before you are hurt.
Peter Aldea MD
Thank you for your excellent question. One of a surgeon's responsibilities is informing patients of their treatment options and their attendant benefits and risks. In cases of aesthetic surgery cases they will also need to discuss with you what would be needed in order to help obtain your goal results. If you do not find the answers that you are looking for definitely seek second opinions from board certified plastic surgeons. Best wishes.
You would be the boss re this in my practice.
If a patient wants to do something that I think is not right, I will tell them and decline to do it. If it is not a matter of health and safety, no harm is done, I respect the wishes of the patient.
I see no big harm done by not suturing your muscle if that is what you wish.