How Do You Know if You Need Muscle Repair During a Tummy Tuck? my Muscles Feel Tight?

I am older and in good phyiscal shape and weight. Loose skin mostly below the bb, but def need bb revision of some sort. My abs feel really right and I have a flat stomach. Haven't had a child in 27 years. Is it possible to get good results from skin only tt? Thanks

Doctor Answers 8

Do I need muscle repair?

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A muscle repair is not an absolute must during tummy tuck.  The best way to determine if you need the repair is to have your surgeon examine your abdominal muscles and feel if there is a space in between the muscles.

How Do You Know if You Need Muscle Repair During a Tummy Tuck?

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This is a great question and one that I am asked quite often during consultations. In general, most patients would do better with a muscle plication (stitching the muscles together in the middle) in order to achieve a "corset" like tightening of the abdomen and sides.  This is especially true in a female with multiple gestation. That said, I have seen many women who truly have tight abdominal muscles and require only skin excision and belly button repair. This is easily achieved with a "skin only" tummy tuck and usually costs less than the standard tummy tuck.  Ask your board certified surgeon during the consultation to assess your abdominal wall tightness to determine the best procedure for you.

  An easy test for you to try is to lay flat on your back with no shirt on and perform a half sit up.  Notice if there is a long bulge down the midline of your tummy.  If so, then you need a muscle repair to improve the results. If the tummy stays tight and strong, you likely won't need a repair. Hope this helps, good luck.

Erez Sternberg, MD
Jacksonville Plastic Surgeon
4.9 out of 5 stars 33 reviews

Never too late

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Thanks for your question. Without seeing your picture it is hard to know. Most TT surgery plicates the muscle in the center to restore it back to its natural position. Often with pregnancy and age the muscle will splay to the side. The diastasis repair reorients the muscle centrally and provides a stronger/flatter abdominal wall. Skin only TT can be done in the patient with exceptional tone and musculature. Every person is unique and it is important to disucss this with a Board Certified surgeon. Best of Luck!

M. Scott Haydon, MD
Austin Plastic Surgeon
4.8 out of 5 stars 92 reviews

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How Do You Know if You Need Muscle Repair During a Tummy Tuck

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If a lax and  protruding abdominal wall is part of the problem, some muscle repair is needed for best outcome. 

If the abdominal wall is solid, and there is no separation of the rectus muscles, you can expect a nice outcome with a skin only abdominoplasty. It is never too late. 

When you are ready for an in person consultation, RealSelf has listings of surgeons in your area. You should consider cross referencing the listings from the The American Society of Plastic Surgeons (plasticsurgery dot org). A listing in the ASPS website assures you that your surgeon is not only board certified,  but also is a member in good standing of the major plastic surgery organization in the U. S. Thank you for your question, best wishes.

Jourdan Gottlieb, MD
Seattle Plastic Surgeon

Muscle repair during tummy tuck

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Hello Never too late in PA.  Regarding your question, yes it is possible to get a good result from a skin only tummy tuck.  However, it has been my experience that most people need some degree of muscle tightening to give a nice hourglass figure, especially with a history of childbirth which usually stretches out the rectus abdominis muscle fascia leading to a condition called rectus diastasis.  Without seeing a picture of your abdomen or doing a thorough physical exam, I cannot say if you are that rare individual where your rectus muscles have rebounded from the stretch of pregnancy.  Your rectus muscles can be directly visualized during a tummy tuck procedure to see if some tightening will help with the aesthetic outcome.  Otherwise, if your loose skin is mostly below the belly button, you may be a candidate for a mini-tummy tuck procedure.  Either way, if you just need loose skin removal, that will significantly decrease your postop discomfort and recovery time.  I would recommend a consultation with a board-certified plastic surgeon to address your concerns and go over your options in more detail.  Hope that helps! -Dr.92660

Parviz Goshtasby, MD, FACS
Newport Beach Plastic Surgeon

You full fill the whole requirements for avoid muscle repair/llenas los requisitos para evitar tocar los musculos rectos

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yes you are a nice candidate to realize a small incition , removing excess abdominal skin besides a lipo  and avoiding to touch both rectus abdominal muscles



si unicamente se podria  realizar un TT con liposuccion  con reseccion de piel pero sin tocar los musculos, es un buen caso  que llena los  requisitos para evitar toicar los musculos rectos  abdominales

Ramon Navarro, MD
Mexico Plastic Surgeon

To tighten or not..

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Yes,  you can get a good result without tightening. It all depends on how tight / wide your muscles are to start with. Generally, most tummy tucks are done after pregnancy which tends to stretch the muscles. 95% of my tummy tucks are with muscle tightening. However, there is the occasional patient with firm tight abs but loose skin and stretchmarks. That is the person would benefits most from a non muscle tightening procedure. 


Hope that answer is helpful. 


Bennett Yang, MD

washington dc


Bennett Yang, MD
Rockville Plastic Surgeon
4.8 out of 5 stars 21 reviews

Tummy Tuck without muscle tightening

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Thank you for your question. It is possible to get a nice result with a tummy tuck without tightening the rectus muscles in the right person. Patient selection is the key, as the muscles need to be tight and toned, and without the separation that is the result of pregnancies in many cases.

The goal of tightening the rectus muscles is to provide a flat, tight foundation that the skin can then be tightened over. This can help restore the waist line and remove the lower belly laxity that some women have. If you have neither of these issues, and skin laxity alone is the problem, then you may be a candidate for a skin only tummy tuck. This will dramatically reduce the recovery time.

The best way to determine the specific options for your belly is through a full consultation. At that time, your plastic surgeon can examine your belly and discuss the options with you.

Best of luck with your belly.

Jeff Rockmore

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.