Inverting rectus muscles with plication - will this affect my ability to use core muscles? (photos)

Typically, tightening your muscles will help strengthen your core. If you need more, EMSculpt treatments can be very helpful, especially to help your core.

I am kind of a believer that surgeons either know how to do procedures well, or they don’t. Redoing the entire operation to get a more aggressive result seems a bit over the top.
That’s a lot to go through and if you’re going to go to the entire procedure again, then maybe you should consider finding someone to get better results in the first place.
I recognize that having your procedure done as a revision may be substantially less expensive than going to a new provider.
It’s important to differentiate what variables are contributing to your current, abdominal contour and appearance. There are generally four variables that determine what the abdomen looks like. These are abdominal skin laxity, excess subcutaneous fat, muscle separation from previous pregnancies and excess visceral or intra-abdominal fat.If you have a bulging after a full tummy tuck, then you need to make absolutely sure that it is insufficient muscle tightening causing this and not visceral fat.
Even slight amounts of visceral fat, will inhibit what can be achieved and being more aggressive with muscle tightening, will not overcome that problem. Your before pictures do not show evidence of excess visceral fat but to get an accurate assessment always requires an examination.
Muscle tightening to the point of actually pulling in the waist is possible and I’ve seen it done. It does require patients not have excess visceral fat, which cannot be overcome by muscle tightening. It requires surgeons being very aggressive basically burying the rectus muscles or inverting them. This will change how your abdomen feels but functionally your core muscles should still be capable of stabilizing your torso. The more aggressive a tummy tuck is the more likely patients are to feel that your body is permanently different after the operation. Some patients have issues with pain, range of motion and stiffness after an aggressive, tummy tuck.
I recognize that you’ve already had the procedure and you are seeking advice regarding having revision surgery. For primary procedures, I recommend patient start by having at least five in person consultations with local board-certified plastic surgeons to begin the vetting process of finding the best provider. During each consultation, ask each provider to open up their portfolio and show you their entire collection of before, and after pictures of previous patients who have similar body characteristics to your own. Your surgeon should’ve done that during your initial consultation. An experience provider should have no difficulty showing you at least 50 sets of before and after pictures of common procedures, like a full tummy tuck. Ask providers to show you a variety of outcomes, including excellent results, average results and results that did not turn out, as well as they had hoped. Providers may be reluctant to do this, and will instead prefer to show you preselected images representing the best results of their career. This is however insufficient to get a clear understanding of what average results look like in the hands of each provider. Judge Tat reults based on who gets the most natural looking belly button with a very low set scar that follows anatomic contours naturally and evenly on both sides.
You did not include an after picture, showing the front of your abdomen.
This is necessary to make a good assessment.
If your surgeon is suggesting doing a procedure differently than Shirley here she must have before and after pictures of previous patients they’ve done this to show you for comparison. I would suggest you ask your provider why this was not done in the best way possible during the first procedure. Perhaps it was discussed and you both made a decision to not be too aggressive.
Without seeing the front of your abdomen, to judge the appearance of the umbilicus and the design of your incision it’s hard to give a good assessment on the outcome of your procedure other than your abdomen shows slight bulging. That bulging is generally speaking more likely to be due to excess visceral, fat, insufficient muscle tightening because most plastic surgeons for muscles fairly tight.
Your case may be different, especially if your provider is talking about needing to re-tighten your abdominal wall.
The revision will be more intense than your first operation, and you should ask yourself if that is a reasonable thing to go through. I would think you would also want clear evidence that this is going to give you a significant improvement on your outcome. Why in the hands of the same provider is the second operation going to give you such an improved outcome?
What time in touch is one of those operations that should be done once and be done correctly. The time to be critical of your surgeon is during the vetting process. When you’re choosing providers.
One way to help differentiate Laxcity of the abdominal wall in comparison to increased intra-abdominal pressure due to excess visceral fat is to see what the abdominal wall contour looks like when you lay on your back. if it improves dramatically when laying on your back, then insufficient, muscle tightening may be a real thing. The contour is fairly similar when you lay on your back, then visceral fat is more likely to be contributing to the contour.
You can also help to some degree how much pressure it takes to press your abdomen flat. Push the muscle while into your abdomen and see if you can do that quite easily, especially with your nondominant hand. If doing this takes a great deal of pressure or the abdomen feels tight when you do it then visceral fat may be contributing and more significant part.
It’s important to make an accurate assessment, because the choice of procedures should be based on having a clear understanding about the underlying problem is. As I mentioned earlier for the Abdomen, there are generally only four variables, and the problem is almost always one or more of those variables. This is generally true whether someone has had surgery or not.
Insufficient muscle tightening is a relatively uncommon in patients complaining about. Tell me a tech results so that is the reason why I’m going on a bit in this response.
I always tell patients when, in doubt, slow down and schedule more consultations, and there’s certainly nothing wrong I getting a few second opinion canceled before you make any decision about permanent and irreversible operations whether it be a primary procedure or a Revision. Recognize that in this case the revision will be more aggressive than the primary procedure.
Best,
Mats Hagstrom MD