Can Muscle Repair Be Done if I Don't Have Separation?

I am worried my tummy won't be flat. When I do the "sit-up" test it feels like my muscles are together...I don't feel any seperation. I had my baby young (20 years ago) when I was 19. I work out regularly but lost about 80 lbs 5 years ago after lap-band. My biggest issue is the extra skin but my stomach sticks out when I am not holding it in, too. Can the doc do MR if you have no seperation??? If I let it out I look 4-6 mos prego.

Doctor Answers 9

Tightening of the abdominal muscles with a tummy tuck or abdominoplasty

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Almost all women do develop abdominal wall weakness and/or muscle separation with pregnancy. In you are in shape and still have abdominal bulging then you do have muscle wall weakness which can be tightened during a tummy tuck or a High Tension Abdominoplasty.

Beverly Hills Plastic Surgeon
4.3 out of 5 stars 51 reviews

Abdominal wall can be flattened even if the rectus muscles aren't widely separated

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With massive weight gain there will be a stretching of the tissues of the abdominal wall which will be even more evident with the subsequent loss of the weight. Thus, even without true muscle separation, there can be increase abdominal laxity and protrusion which is related to the fascia and (other) muscles having been stretched out. These can be retightened by strategically placed sutures, providing a more sculpted and flatter appearance.

You should seek a consultation with a board certified plastic surgeon who can evaluate you and make the appropriate recommendations. At that time, they can also professional assess whether you have separation of your rectus muscles or not.

Steven Turkeltaub, MD
Scottsdale Plastic Surgeon
4.7 out of 5 stars 33 reviews

Fascial tightening during abdominoplasty

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Patients think that the tummy tuck is just to put muscles back together that have separated.  This is not the case.  Tummy tucks tighten the fascia and diminish the circumference of the waist.

In very fit women, many notice that their waists have widened since childbirth; a small incision tummy tuck (or endoscopic type tummy tuck) can narrow the waist.  Women often notice that they have large bloating with abdominal distention after eating certain meals, and did not have this prior to childbirth.

That said, your abdomen looks pretty good indeed, and I am not sure how much fascial looseness there is to be tightened!

Brent Moelleken, MD
Beverly Hills Plastic Surgeon
4.9 out of 5 stars 195 reviews

Muscle tightening during a tummy tuck!

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The technique for muscle tightening is to pull each muscle together in the midline. The tissue between them buckles underneath. The same procedure can be performed if the muscles are not separated - only muscle will buckle underneath. 

In either case we can make the muscle tight and flat so that a quarter can bounce off it and flip a few times!

Good Luck!

Robert M. Freund, MD
New York Plastic Surgeon
4.8 out of 5 stars 34 reviews

Can Muscle Repair Be Done if I Don't Have Separation?

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I would be certain that, whatever the state of your muscles, they could be improved by a rectus repair during the course of your abdominoplasty.

It is very likely that your muscles are separated after a pregnancy, even if you had your child at a young age.

Furthermore before you lost 80 lbs you were probably carrying some weight inside your abdominal cavity. This would also have stretched out your muscles.

Good luck!

Muscle repair without diastasis in tummy tuck

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It is possible to 'repair' or tighten the fascia over the muscles after significant weight loss despite the fact that there is no diastasis or separation of the sit-up muscles. Abdominal contour and tone can be improved. Keep in mind however that all of us can relax and thrust the stomach forward. Part of exercise is improving posture and tone and avoiding the slouch look, or letting it out.

Best of luck,


Peter E. Johnson, MD
Chicago Plastic Surgeon
4.0 out of 5 stars 44 reviews

Muscle repair without separation of the rectus muscles

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Re your picture: if you are not "sucking up your gut" I think your rectus definition and abdominal "hourglass" are fine and you should be congratulated for what you have done.

If you have redundant skin that can be removed with a paniculectomy( skiin excision) depending on how large it is

Barry H. Dolich, MD (Retired)
Bronx Plastic Surgeon

Muscle Tightening and the Tummy Tuck (Abdominoplasty)

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Dear Gymcat:

Congratulation on the massive weight loss. The laxity you are describing, like you are 4-6 mo pregnant when you relax the abdominal muscle, is most likely from the fascia getting stretched out of shape with childbirth and weight gain. The fascia is a tough layer that surrounds and supports the muscles. Loosing weight will diminish the bulge, but when you relax, the loosened fascia allows the abdominal contents to push forwards.

Tummy tucks normally tighten the fascia. It is not necessary that a frank separation (diastasis) is present. This will support the abdominal muscles like an internal corset, and frequently gives more definition to the waist. Looks like you are in great shape. Good luck.

Joseph Mele, MD
Walnut Creek Plastic Surgeon
4.5 out of 5 stars 17 reviews

Tummy Tuck after lap band surgery

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Firstly, I think you look great and would like to congratulate you on loosing the weight and keeping it off.  Secondly many people who are heavier have muscle laxity even wihout a muscle separation, and this does not get better with weight loss.  The muscle should be tightened at the same time tha extra skin is removed to eliminate your looking like you are 4-6 mo pregmant when you relax.   Good Luck

Beverly Friedlander, MD
Short Hills Plastic Surgeon
4.8 out of 5 stars 19 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.