If oblique tightening is legitimate why don't all plastic surgeons do this? (Photos)

I have a procedure that I call "waist enhancement," which is tightening of the external oblique fascia that trims and sculpts the waist. Not all patients are candidates nor do all patients want it so I offer it as an add on procedure. It is a fabulous procedure I consider to be the icing on the cake for the right patient. You look amazing for having 10 babies! You appear to be a great candidate for a tummy tuck with waist enhancement. Be sure to consult with a board certified plastic surgeon. Good luck.

The abdominal wall can be tightened during the TT through a process called plication (rectus muscle plication as well as oblique muscle plication). I would not focus on what is proclaimed as better.   The considerations in creating the best result are manifold and do not lend themselves to easy interpretation. If the waist was smaller at one time, the waist can likely be reduced to those same measurements or smaller provided the muscular and fascial integrity has remained the same. All the procedures I perform are videotaped.  Find a board certified plastic surgeon who performs this surgery hundreds or thousands of times and has demonstrated prowess. Kenneth Hughes, MD, ABPS Board Certified Plastic SurgeonLos Angeles, CA

Hello,Oblique muscle tightening or mesh will not give you more of an hour glass figure than standard rectus muscle plication and subcutaneous liposuction of the waist area. The degree of cinching is limited by the deeper structures of your torso: rib cage above, intra-abdominal girth in the middle, and the pelvis below. Muscle plication with or without mesh (which is never recommended in non-reconstruction cases) cannot compress the deep structures of your mid-section into a smaller circumference. That's fantasy. 

The technique I recommend is abdominoplasty with mesh reinforcement, if you are not planning future pregnancies.  The mesh creates a more hourglass figure by compressing the abdominal wall resulting in early satiety and helps maintain a reduced weight.Best Wishes,Gary Horndeski, M.D.

If a patient is a candidate - in our Practice oblique tightening is performed. Keep in mind that the hourglass figure - is more dependent upon the patent's natural anatomy. You have the makings for improvements of your figure- in the right hands- but there are limitations as to how small the waist can be reduced. I agree with your assessment of Miami... 

Hello and thank you for your question. Based on your photographs and pregnancy history, you are a great candidate for a tummy tuck with liposuction.  This can be done through a low and short incision, all completely below the bikini line.  The belly button can be designed to look natural and have no scars on the exterior.   Your muscles can also be plicated resulting in a flat abdomen.  I perform oblique plication only in patients with lateral fullness which you likely don't have.    Make sure you specifically look at before and after pictures of real patients who have had this surgery performed by your surgeon and evaluate their results.

Best wishes and good luck.


Richard G. Reish, M.D. FACS

Harvard-trained plastic surgeon
 

Dear turtle tummy,
based on your photos, you look like a good candidate for a TT. Full tummy tuck should tighten your abdominal muscles and remove the excess skin. I would suggest you to consult a board-certified plastic surgeon because only after a thorough examination you will get more information and recommendations.
Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Hello and thank you for the question.You are an excellent candidate for an abdominoplasty. Rather than focusing on one specific technical part of the procedure, I would highly recommend that you see a board-certified plastic surgeon with experience in performing body contouring procedures. Ask your surgeon to show you before and after pictures of his/her patients and see if you like their work. Also, pay attention to the facility and make sure they have the adequate credentials for performing these type of surgeries. Best,

Thank you for your pictures and questions. You appear to be a good candidate for a tummy tuck procedure. Do not be fooled by flashy names and good advertising. Make sure you are seeing a local plastic surgeon who is board certified by the American Board of Plastic Surgery. Every patient requires a unique approach to abdominal tightening and that is determined at the time of surgery. Most patients do well with midline repair of diastasis, while some require additional suturing. Bottom line is that there are plenty of surgeons in your area who will do a great job with your procedure, do not fall under the false pretense that you need to travel to some "expert" to get a good result, that is all advertising. If you have not been to any consults with board certified plastic surgeons (ABPS) in your area, start there. And do not at all be surprised if the surgeons are not willing to videotape the procedure. Any good surgeon wants to spend his or her time and energy concentrating on the patient and the surgery, not being a videographer. Reconsider your priorities, they should be choosing the right surgeon and your safety!Good luck!Dallas R. Buchanan, MD, FACSOwner & Board-Certified Plastic SurgeonVIVIFY plastic surgery

Thank you for sharing your excellent question and photographs.  Nothing replaces an in-person examination, but I think you would most benefit from a full tummy tuck and liposuction of your waist and flanks.  The tummy tuck will tighten your stomach muscles, helping to achieve a flatter appearance, while removing excess skin and adipose tissue.  Tightening is done in whatever direction the patient has continued muscle laxity in - typically vertically along the middle of the stomach because of the separation and stretching that occurs here during pregnancy.  If patients have continued muscle laxity along their obliques, then tightening is pursued here as well to achieve the best results possible.  Hope this helps.