Why does my MR keep coming undone. How can I prevent this from happening again? How is tummy supposed to look after MR? (Photos)

I had my TT MR HR on11\30\15 no Lipo. All went okay then had light Lipo in Feb & then by May my MR undone . had 2nd MR 6/16/16 I was FLAT then. My,surgeon didn't fix my belly button second time and it was messed up so by end of August I needed a 3RD MR. 9\29 33rd MR done was told Belly button was detached. Now a week out of surgery I feel my MR might be undone due to coughing. Why does this keep happening and what can I do to prevent it.I just want to feel normal again.

Doctor Answers 8

Why does my muscle plication keep coming undone after tummy tuck.

I am sorry to hear about the problems you are experiencing. There are probably a combination of factors involved here.  Basically, if you remain concerned about the abdominal wall prominence, it is most likely related to intra-abdominal ("visceral") contents including adipose tissue.  Therefore, I would avoid further surgery for now. Instead, focus on healthy diet/exercise and weight loss; you will find that the appearance of your abdominal wall will improve with this regimen. Then, if abdominal distention remains a concern, plication  of the abdominal wall will be more effective in achieving the aesthetic outcome you are looking for.

 Best wishes.

Did my muscle repair come apart?

 It is unlikely that your  fascial plication ("muscle repair")  came apart.  What is more likely is that:

1) you have fat around your intestines causing your abdomen to pouch out.


2) you  are not using your core muscles enough. 

Fascial plications sutures only bring the muscles back to the midline, they cannot be relied on to keep your abdomen flat. Your core muscles and posture do that. That means when you're walking and sitting and driving etc. you need to  keep your muscle tone active.  Just letting it "all hang out" at all times does not work for anyone  and stitches will not keep a tummy flat. You do. 

 Secondly, the abdominoplasty operation ("tummy tuck"),  is best done on people who have achieved close to their ideal weight.  It is recommended that some weight be lost prior to this operation if this is not the case.  This helps decrease the amount of  visceral fat ( fat around the intestines and internal organs)  and generally  leads to a more optimal result.

Orna Fisher, MD
Las Vegas Plastic Surgeon
4.4 out of 5 stars 13 reviews

Muscle repair

It is extremely uncommon for a muscle repair to release and require revision. Sometimes the sutures may "pop" after early exertion or may weaken due to weak tissues.  You would need to be seen in person.

Steven Wallach, MD
New York Plastic Surgeon
4.1 out of 5 stars 24 reviews

Muscle repair

Thank you for the photo and question and though an examination would be helpful. You may need a mesh added to your repair to better secure it

Dr Corbin

Frederic H. Corbin, MD
Los Angeles Plastic Surgeon
4.9 out of 5 stars 58 reviews

Why does my MR keep coming undone. How can I prevent this from happening again? How is tummy supposed to look after MR? (Photos)

Thank you for the question and photos. I agree with the previous comment on how good the quality of your fascia is. Any increase in intraabodominal pressure can result in separation of your repair. Therefore, it is essential to manage this for example cough, straining, constipation, etc can contribute to increase abdominal pressure. Also it is important to wear a garment to help with this which you may be using. Also in these types of situations weight loss may help as it may help with intraabdominal fat. It I should best to discuss this with a board certified plastic surgeon. Good luck.

Your complicated history of disrupting your muscle plication

is concerning and my first question would be how good is your muscle fascia that is used to hold the sutures used in plication.  If thin and its truly pulling through as your history suggests, a very complex procedure using circumferential mesh would be needed and rather than doing that, it would be suggested that you enjoy the benefits of your procedure, even if not perfect.  But with your tummy that you started with, I'm doubtful anyone would guarantee the results you would get... my patients similar to you are always told to expect revisions.

Curtis Wong, MD
Redding Plastic Surgeon
4.8 out of 5 stars 32 reviews

Why does my MR keep coming undone?

Thank you for sharing your question and photographs and I am sorry to hear of your MR recovery issues. It is difficult to offer definite recommendations without an in-person examination and review of your complete medical/surgical repairs.  If a muscle repair failure is to occur it typically happens in the first 6-8 weeks after surgery, while yours have apparently happened months after.  Based on your pictures I believe your visceral fat - fat deep to your stomach muscles - is causing your muscle repair to stretch and relax.  This is causing your initial flat appearance after surgery to be a more protuberant one over time.  Though ensuring an appropriate muscle repair was performed is the first step I would discuss the best diet and exercise options of reducing your visceral fat with your surgeon.  Hope this helps

Nelson Castillo, MD
Atlanta Plastic Surgeon
5.0 out of 5 stars 38 reviews

MR comming undone?

It's not that your MR is coming undone, its because your entire abdominal muscles have thinned out; so as you plicate the muscle lining in the middle, the more lateral aspect of your muscle lining stretches out thereby making your belly stick out. What you need is a Triple Modality with direct plication, bilateral component separation, and Xenograft. This will prevent future stretching out of your fascia. Please see results below.

Arian Mowlavi, MD
Orange County Plastic Surgeon
4.9 out of 5 stars 41 reviews

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.