Was told by surgeon that pulling abdominal muscles very tight during TT would not affect Pelvic Floor Prolapse Issues, true?

My obgyn and physical therapist said it would be okay that I have a tummy tuck despite some of my mild pelvic floor prolapse issues. During a consult I asked the surgeon to not pull the muscles too super tight as to not add any unecessary pressure. He told me that he will pull them very tight but that I shouldn't worry about it affecting my pelvic floor. Does this sound right or should I keep consulting?

Doctor Answers 8

There is no increase in intraabdominal pressure with a tummy tuck

Thank you for your question.  It has been shown in an experimental study in which a pressure transducer was placed in the bladder of several patients having the muscles tightened during a tummy tuck.  This allowed the researchers to measure the pressure in the abdomen before, during and after the surgery. They found that there is no appreciable increase in the intraabdominal pressure during or after a tummy tuck.
Good luck with your surgery. Make sure that you are seeing a board certified plastic surgeon.

Columbus Plastic Surgeon
4.8 out of 5 stars 38 reviews

Pelvic floor prolapse and tummy tuck

Before a week ago, I would have told you that there is not much to worry about. But I just recently had a patient who had a recurrence of a surgically repaired pelvic floor prolapse after her abdominoplasty. This could have been a coincidence or it could be that the increased abdominal pressure from the rectus plication contributed to the recurrence. I think that you need to understand that there could indeed be a relationship between the tummy tuck and the pelvic floor stability and that it will be an additional risk to your procedure. The risk of having pelvic floor problems is still likely quite low, but not zero. Avoiding excessive tightening of the abdominal wall might be a good decision.

Wm. Todd Stoeckel, MD
Raleigh-Durham Plastic Surgeon
4.8 out of 5 stars 84 reviews

Was told by surgeon that pulling abdominal muscles very tight during TT would not affect Pelvic Floor Prolapse Issues, true?

In standard tummy tuck surgery, the rectus muscles are tightened routinely. This will lead to increase in intra-abdominal pressure. There is no easy yes or no answer.
The question is how tight is muscle tightening? It varies among different plastic surgeons. Also, how bad is your rectal prolapse? Is it going to worsen by time?
In my personal opinion: I would address the rectal prolapse first and then consider the tummy tuck surgery.

Maan Kattash, MD, FRCS, FACS
Los Angeles Plastic Surgeon
5.0 out of 5 stars 19 reviews

Pelvic prolapse and abdominoplasty

Its often helpful to have another consultation opinion, even just to confirm your first impression.  The main issue with pelvic prolapse is a loss of support of the pelvic structures, and any increased abdominal pressure will be secondary, and is unlikely to affect the prolapse. 

I am not aware of any link between plicating the abdominal muscles during abominoplasty and worsening prolapse.  

Thomas A. Pane, MD
Palm Beach Plastic Surgeon
4.2 out of 5 stars 45 reviews

Pelvic Floor and GYN

Sometimes in medicine we just make our best guess. To my knowledge, there is no study linking abdominoplasty with rectus repair to worsening prolapse. Fixing diastasis is about returning things to an anatomic position. There is not evidence of a dramatic increase in intra-abdominal pressure as a result and the repair of your diastasis would not, per my understanding, worsen your GYN issues. This study has not been done to my knowledge.
Dr. Pyle

Jeremy Pyle, MD
Raleigh-Durham Plastic Surgeon
5.0 out of 5 stars 115 reviews

Pelvic prolapse and abomenal pressure with tummy tuck

You are correct to consider another consultation.  A tummy tuck with tight muscle imbrication will increase intra-abdomenal pressure and could aggravate pelvic floor prolapse, even raise your diaphragm position.  Best to seek a uro-gynecology specialist to work with your plastic surgeon on staging your strategy.

Randy Wong, MD
Honolulu Plastic Surgeon
4.8 out of 5 stars 36 reviews

No link from tighting your abdominal muscle and rectus prolapse

Every abdominoplasty surgery should tight the abdominal muscle as much as to reconstruc the normal anatomy of the abdomen and no more, therefore it should not be a problem or repercussion to the pelvic floor. You should worry about getting a good surgeon to repair your pelvic floor and you can do this surgery before or after your tummy tuck.

Ricardo Ventura, MD
Dominican Republic Plastic Surgeon
5.0 out of 5 stars 30 reviews

Abdominoplasty and Pelvic Floor

Abdominoplasty procedure removes excess loose skin and tighens the weakened, distended abdominal wall. The procedure does not influence the pelvic floor.

Craig Mezrow, MS, MD, FACS
Philadelphia Plastic Surgeon
5.0 out of 5 stars 17 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.