Full tummy tuck without muscle repair? (photos)

I am scheduled to have a full tummy tuck without muscle repair and breast implants on Dec.22nd. I have had 3 pregnancy all via c-section. My doctor made me lay down and do a sit up so he could feel my muscles. He said I would not need muscle repair (I'm a complete gym junkie so I do a lot of ad workouts). However after doing a lot of research I am a little concerned my belly isn't going to be as flat since it is rare not to have no muscle work done. Any suggestions based off my pics? Thank you!

Doctor Answers 19


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I do muscle repair on almost every abdominoplasty, unless the patient requests we do not. I think any woman who has been pregnant probably needs the abdominal wall tightened.

Greg Sexton, M.D.
Columbia, S.C.

No muscle repair with Tummy Tuck?

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In general, most women who have had 3 pregnancies will have some laxity to the abdominal wall musculature.  The fact that you exercise actively may have reduced this significantly in your case and therefore negate the need for muscle repair.  Only a formal exam with your surgeon can determine the amount of laxity you have and whether repair is indicated or not.  Discuss this further with your surgeon and let him/her know of your concerns prior to your surgery so that you are both on the same page.

David F. Klein, MD
Concord Plastic Surgeon
5.0 out of 5 stars 22 reviews

Tummy tuck without muscle repaur

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Usually after three children, there is enough skin laxity to have a full tummy tuck. In my opinion, after three pregnancies some amount of space exists between your six pack muscles no matter how strong they are. So I always tighten muscles to some degree and that amount is determined once I am looking at them in the operating room. Just have a conversation with your surgeon. Best wishes. 

Repari the muscle or not with tummy tuck

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Thank you for your question and pictures.  While an exam helps to asses the muscle separation or diastasis present, I typically would also evaluate it at the time of surgery when I am looking directly at the muscle.  At that point I would make my final decision on repairing it or not.  With regard to whether a mini or full tummy tuck is necessary that would need an in person exam to determine how much stretch or loose skin is above the belly button. 

Best wishes,

Dr. Joseph

Brian Joseph, MD
Orlando Plastic Surgeon
4.8 out of 5 stars 52 reviews


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Hello dear, thanks for your question and provided pictures with information as well. This is the surgical procedure in which excess skin is removed, and the weakened muscles of the abdominal wall are strengthened. Other defects can also be corrected, such as decreasing excess fat and eliminating scars and stretch marks below the navel caused by pregnancy, aging, and massive weight loss among other factors. Abdominoplasty can be performed along with other procedures such as liposuction, breast reduction and augmentation. You have to get a consultation with a board certified plastic surgeon, you will get much better results! Beautiful shape.

Tania Medina de Garcia, MD
Dominican Republic Plastic Surgeon
4.6 out of 5 stars 441 reviews

Full tummy tuck without muscle repair? (photos)

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Based on the photos, I would recommend liposuction of the abdomen with a mini tummy tuck. I think this would address the loose skin that appears to be primarily below the belly button. This procedure leaves the belly button where it is now (no incision around the belly button) and does not require any muscle repair. An in person consultation will allow for a better assessment of your tissues. Best of luck!

Muscle Plication during Tummy Tuck

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An abdominoplasty or tummy tuck, usually entails both a plication (bringing together) of the rectus muscles and removal of excess skin and fat. It is not rare, but very unusual, to have only skin removed with a history of three pregnancies. Most women do usually benefit from some muscle work unless there is a need to speed along the recovery process. It is the muscle plication that usually is the most uncomfortable. Wishing you all the very best

Bahair Ghazi, MD
Atlanta Plastic Surgeon
5.0 out of 5 stars 49 reviews

Might be some non surgical options.

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With the disclaimer that I am responding to your inquiry with your history and photos only, and without the benefit of an examination in person, because you are in such excellent shape, there may be a role for a non-surgical option before proceeding to an abdominoplasty. There are radio frequency devices that can accomplish skin tightening either with a totally non-invasive modality (Tripollar Legend), or with a "micro-invasive" or minimally invasive device (ThermiRF). You might want to give this consideration. 

Best of luck to you, whatever you decide. 

Ram Kalus, MD
Mount Pleasant Plastic Surgeon
4.8 out of 5 stars 24 reviews

Muscle repair

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You look like a great candidate for a tummy tuck. It is rare in my practice to not repair the muscles, especially in someone who has had three pregnancies.  The muscles are almost always stretched to some degree and in order to get the flattest shape they need to be repaired. Perhaps you could all to your surgeon about your concerns and talk about the pros and cons of muscle repair.  It does add some time to recovery but the long term results are worth it 
good luck 

David R. Alfonso, MD, FACS
Grand Rapids Plastic Surgeon
5.0 out of 5 stars 66 reviews

Can't tell from pictures

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You have certainly kept in great shape.  The "full tummy tuck" I am presuming means you have enough upper abdominal skin laxity for that procedure.  From your pictures, I don't see that.  I also have no idea what, if any, amount of muscle laxity you have after your pregnancies.  MOST women that have had children have some and would benefit from muscle repair/plication, but occasionally the muscle repair is not necessary.  From your pictures (and I say this with caution), I think you would get a great result from a mini-tummy tuck that addresses the extra skin and tissues below your belly button and that you PROBABLY don't need your muscles tightened.  It would be best to give you advice after examining your abdomen though.  Have you gotten a second opinion?

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