Muscle plication - what to do when it fails.
The muscle plication (erroneously termed a "repair") in a tummy tuck relies on two main factors for success - 1. The sutures must hold the plication, 2. The patient must comply with garments, lifting/activity restrictions.
It is unusual for the sutures to "fail" from a plication. However, a bulge can occur if the knot breaks or the sutures tear through the fascia. More commonly, patients return to activities sooner than advised and prior to the scar being strong enough to resist the activity. I restrict activities which stress the plication for 3 months post surgery and keep all of my abdominoplasties in compression for a minimum of 6 weeks. Although no postoperative routine is a guarantee, these limitations have made bulges a rare occurrence in my practice. As for who pays for a revision, that depends upon the office's revision policy.
Like anything else it wouldd epend on the cause.soemtimes this is due to an uncoperative patinet or their having poor tissues.so the cause is what determines what to do.
Handling a Failed Muscle Repair
As part of an abdominoplasty a "failed" muscle repair may have many causes such as regaining of weight, return too quickly to strenuous activity, poor fascia (muscle covering) strength, broken sutures, frequent straining, etc. If the cause is know, then a repair can be considered. There are rare cases when the fascia may not be able to maintain the repair due to high pressures in the abdomen.
Result of an abdominoplasty did not meet expectations
One can only imagine that by failed muscle repair you mean that you still have an abdominal bulge after an abdominoplasty with a complete fascial repair. It would be good to look at pre and post op photos to understand your concerns. Most plastic surgeons have policies regarding secondary or revision surgery. If you are not happy with your result discuss this with your surgery and hopefully there is a mutually acceptable solution.
Failed muscle repair after abdominoplasty is rare.
Failure of repair of the fascia after abdominoplasty is extremely unusual. If it were to occur in one of my patients there will be no professional fee assessed for a revision.
Without knowing exactly what is meant by "failed muscle repair" I am not sure how to respond. This description could fit a patient whose sutures pulled through in the recovery room from a single cough,, and could fit a patient who is quite overweight and expected more contouring than was possible. Obviously these are very different situations.
Most offices issue written policies about revision surgery. Often there is a reduced surgeon's fee or none at all, but usually there will be a fee for the operating room and anesthesia.
What surgeons answering on RealSelf would do will not likely be identical to your surgeon's policy. A discussion about any areas of disatisfaction with your surgeon is the starting point. All the best.
How to handle failure of muscle repair administratively
This is a very difficult question to answer in this forum as it is worded. The actual issue is very complex and involves many factors. First, it is important to know exactly what is meant by "failed." If we are talking about simply a less than satisfactory result that is one thing, but a complete recurrence of diastasis recti is another. Additionally, I might consider any factors that may have led to a failure, such as weight gain or history of excessive activity stressing the repair against medical advice. It is also important to know how long it has been since the surgery. For these reasons, it is imperative that you have an open discussion with your surgeon to arrive at a mutually agreeable way to handle the situation between the two of you. Other surgeons and patients may find a different way that works for them, and that is really all that matters. There is no strict rule as to how this has to work. In general, most surgeons will have a written revision policy that the patients should sign prior to undergoing surgery, and this is the place to start all of these discussions. Good luck.
Policy to Repair Failed Muscle Repair after Tummy Tuck Surgery?
Difficult to answer without knowing more specifics, but many plastic surgeons would offer revisionary surgery with no surgeon's fees; anesthesia and surgery center fees may apply. Of course, your chosen plastic surgeon will likely have written “policy” in this regard.
Hope this helps.