Thank you for the question. Ultimately, you will need to do your due diligence and select your plastic surgeon carefully. Then, after this careful selection, you will be best off going with his/her judgment. Generally speaking, the vast majority of patients who present for tummy tuck surgery benefit from muscle plication; as you know, this part of the tummy tuck procedure serves to re-approximate the muscles that have spread during pregnancy or weight gain/loss. Omitting this part of the procedure will potentially leave patients with continued abdominal wall laxity and, in my opinion, a less than optimal result. If you remain in doubt, seek additional consultations with well experienced board certified plastic surgeons who can demonstrate significant experience helping patients achieve the types of outcomes you would be pleased with.
A physical exam will let me know if you need muscle plication. If you do, we use a local anesthesia post op that gives you three days of pain relief. So don't worry .
Thank you for the question.
If a tummy tuck is the procedure diagnosed to be the best one for your case, it will include abdominal muscle repair. This really depends on how much skin laxity you might have when your PS gives you the evaluation.
Rectus plication (muscle repair) is not always needed with abdominoplasty (tummy tuck) especially if you have not had children. Some women still have laxity in the abdominal wall even if they have never been pregnant. This could be hereditary or congenital or due to massive weight loss. These patients still benefit from tightening of the abdominal wall with the skin removal that involves a tummy tuck.
Separation of the abdominal muscles is called diastasis recti and can lead to unsightly bulging of the abdomen. Repair at abdominoplasty can improve the bulge but is often associated with pain. This condition is more likely to occur following child birth but may occur for other reason in both men and women. A physical examination is necessary to determine whether muscle repair should be performed with abdominoplasty.
Muscle repair is only needed if there is laxity in the abdominal wall, or the muscle/fascia layer. This layer is usually stretched out in pregnancy, but sometimes gets stretched out just by weight gain alone. Your PS can check to test this layer by lying you down and have you do a small sit-up. Your muscular wall, if normal, flattens and pulls in. If the wall is stretched out or there is a rectus diastasis (split muscle), your abdomen will bulge when you do a small sit up.
If the rectus muscles have separated from either pregnancy (most common cause) or weight gain, then a repair as part of the tummy tuck will give a better result. The only way to know is with an exam, but with no prior pregnancy you are less likely to need it.
Muscle repair is the norm but not a necessity in women after pregnancies or in patients who have lost dramatic amounts of weight. After an exam your surgeon will be able to tell you if she/he feels the repair is necessary.
Thank you for your question muscle repair during tummy tuck is only needed if you have a diastases recti or a split muscle. This condition is almost always caused by pregnancy, therefore iif you have not had children will likely not need a muscle repair.
An abdominoplasty procedure (tummy tuck) should treat the problem of abdominal laxity by removal of extra skin and fat and tightening the muscle layer (fascia) if needed. Sometimes, if a woman has never had a full term pregnancy, the abdominal muscles will be fine and no tightening will be necessary.