Is Triple Plication common practice?

Question

Hello, I am looking to get a mommy makeover. Well, first I want to lose 10 more pounds. I want as much lipo done to give me a snatched waistline (eliminate any lovehandles), bra fat and of course the tummy tuck. I am concern about the scar not being low enough or not being straight. My main question is about triple plication. Is this common practice? Does it make a difference? I have been seeing more and more about it and I wonder if it is worth it. Thank you!

Nelson Castillo, MD · Answer

Thank you for sharing your question and photographs.  More a marketing term than a specific procedure, all surgeons repair muscle laxity at the time of the tummy tuck to address areas of laxity, the most common of which is central.  I would focus more on the results of the surgeon you visit then in how they achieve them.  Hope this helps.

Emmanuel De La Cruz, MD · Answer

Triple plication is a technique used during a tummy tuck (abdominoplasty) to tighten and reinforce the abdominal muscles. It involves creating three layers of internal sutures to strengthen the abdominal wall.

While the term "triple plication" might not be universally used, the concept of reinforcing the abdominal muscles by placing multiple layers of sutures is a common practice in certain abdominoplasty techniques. The goal is to achieve a more tightened and toned appearance in the abdominal area.

The specific techniques and terminology might vary among surgeons, but the idea of creating multiple layers of internal sutures to address muscle laxity is a recognized method in abdominoplasty procedures.

During your consultation with a plastic surgeon, they will explain the techniques they plan to use and how they will address muscle laxity to achieve the desired outcome. Understanding the surgical approach and techniques employed by your surgeon will help clarify any terminology and ensure you're well-informed about the procedure being performed.

Frank Agullo, MD · Answer

Triple plication gives better waist definition during tummy tuck surgery because it addresses both the rectus muscles and the oblique muscles. While traditional tummy tucks only repair the separation between the rectus muscles down the middle of the abdomen, triple plication involves making additional muscle repairs on either side of the abdomen. By plicating the oblique muscles, triple plication can create a more defined and contoured waistline, resulting in a smaller waist and a more defined hourglass figure. This technique can provide a significant improvement in the overall contour of the abdomen, resulting in a more shapely and attractive figure.
Triple plication has been well described in the Brazilian and American plastic surgery literature. Not all plastic surgeons are aware of triple plication or have been trained to perform this technique. It is essential for patients who are interested in this technique to do their research and seek out a board-certified plastic surgeon who has experience with triple plication and can discuss the risks and benefits of this technique. Choosing a skilled and experienced surgeon is critical to achieving optimal results and minimizing the risks associated with any surgical procedure.

Casey Anderson, MD, FACS · Answer

Triple plication seems unnecessary. The most common practice is to do one or two layers. I believe most surgeons do a 2 layer plication.

Elisa A. Burgess, MD · Answer

For my patients they usually don't need a triple plication but every surgeon approaches things differently. I think most surgeons think about a triple plication with the three being one central and one on  each side. I think the most important area is the central plication to repair the rectus diastasis. Make sure to see a board certified plastic surgeon with experience.

Robert M. Tornambe, MD · Answer

I appreciate your concerns however it sounds like another marketing technique to try to stand out from the rest of us.
 The so-called triple placation technique simply refers to additional plication on the sides along with plication down the central portion of the abdominal wall. This is not necessary in many patients as the central plication technique is usually enough. If the abdominal wall is extremely lax, then plication laterally usually in an oblique fashion on either side is then performed. This is nothing new! Consult with a board-certified plastic surgeon in your area to explore the best options for you. Good luck.

Gary M. Horndeski, MD · Answer

When I do a tummy tuck, I use a plication to the midline and also use bilateral and lateral plications. So there are actually 3 plications. If you are not planning future pregnancies, I recommend abdominoplasty with mesh reinforcement. 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.

Best Wishes,

Gary Horndeski, M.D.

Daniel Barrett, MD · Answer

Dear Btlginn1,
it is hard to tell for sure without an examination. If you are considering a surgery, I would suggest you to consult a board-certified plastic surgeon. 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

Camille Cash, MD · Answer

Your surgeon should be able to better explain what you can expect in terms of results.  When selecting a surgeon, review before and after photos on the surgeons' websites and schedule a consultation with those that meet your criteria.  Select the one with whom you feel most comfortable and confident.  Specific techniques and the rationale behind them can be explained at your consultation.  It's easy to say one technique is preferred over another, but the question you want answered is "why".

Mats Hagstrom, MD (license on probation) · Answer

I wouldn’t worry so much about the terminology. Instead focus on finding the best plastic surgeon in your area.

If you contact me directly by email or sending a request for a consultation I’ll give you the name of the one single provider who in my opinion does the best take me a text of anyone I’ve ever seen.

This was one of my professors who is to this day the greatest plastic surgeon I’ve ever met.  He truly gets the absolute best results.

Otherwise the following are some general recommendations for patients to get the best results and have an overall positive experience.

I recommend patients avoid traveling long distances for elective surgical procedures. There are of course instances where there is a lack of local talent and traveling to some degree is inevitable. If traveling for the procedure patients should be ready to travel to have the consultation, post operative appointments and follow up should there be issues or complications.
Patients sometimes do not appreciate the importance of in person consultations, that complications do happen or the number of people who have issues with their results or need revisions.

Schedule multiple consultations with different providers in your area who seem to have a good reputation for the procedure you’re interested in. Starting with at least five consultations seems like a reasonable number to me.

Whenever possible schedule in person consultations.  
During in person consultations ask each plastic surgeon to show all of their before and after pictures for the procedure you’re interested in.

The goal is not to see the best results of their career but to get an idea of what average results look like and get some type of confirmation of how many of these procedures that provider has performed.

Ask to see results that were not as good as the doctor would’ve hoped for and talk about the differences in outcomes.

Honest and experienced providers should have no problems presenting this type of information.

A highly experienced plastic surgeon should have hundreds of before and after pictures for the procedure you’re interested in. At a minimum at least 20+.

Read all the reviews on various physician review websites paying close attention and avoiding providers with any significant number of justified negative reviews.  Providers with an abundance of reviews often have aggressive marketing campaigns.

The plastic surgeons I respect most all have the single variable of not having justified negative reviews on their online profiles. 
In my opinion justified negative reviews are far more telling than an abundance of positive reviews.

Avoid scheduling for surgery or making a deposit on the day of the consultation.  Give yourself some time to think about the decision and make sure you finished all scheduled consultations before committing to having surgery that will permanently and irreversibly change your body.

When in doubt slow down and schedule more consultations.

Choosing the right plastic surgeon is the single most important variable to having a positive experience.

Don’t go chasing after technology or names of certain equipment. Instead focus all your efforts on finding the most experienced and talented board-certified plastic surgeon.

Best,

Mats Hagstrom MD

Is Triple Plication common practice?

Answers (11)

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