What caused my failed muscle repair six months after TT? Is the second repair likely to fail? (Photo)

I have no idea why an abdominal wall repair would fail six months after abdominoplasty. There may be some underlying connective tissue issue such as Ehlers Danlos syndrome.

There are several factors that can explain your situation.  First, there is a limit to the strength of the abdominal wall fascia (the top layer which is sutured together).  Sometimes this layer is sutured as tightly as possible but "gives back."  This situation is basically genetic.  Second, every time the abdomen is tightened the surgeon must use judgment to determine "how tight" to pull.  Perhaps you can be further tightened.  For that layer I use non-dissolving sutures.  Finally, early exercise or weight gain can stretch out the repair.  Best of luck!

Thank you for the pictures -- however, it is still difficult to assess if there truly is a failed muscle repair or not.  Your surgeon has to give you a thorough examination lying down, and also bearing down to evaluate the integrity of the muscle plication (i.e. the muscle tightening repair with stitches).  However, if there is a doubt, the only definitive way to check the muscle repair is with an imaging study (CT or MRI).  In terms of your future outcome after this next surgery -- your muscle may just be thin, in general, and a little bit of stomach muscle laxity may be inevitable.  I'm not exactly sure what you mean by clamps, but some surgeons may use a mesh support during the surgery.  Your post-operative outcome can also be improved with strict adherence to your surgeon's post-operative activity recommendations (including abdominal binder use), and then a careful abdominal muscle strengthening program once you are completely healed from the surgery -- at least 6 weeks out.  Of course, make sure you maintain good nutrition and refrain from any smoking (if you are a smoker).Good luck.