Does the integrity of fascia impact the tummy tuck outcome?

Question

Excited to have a tummytuck after I have my third and final child. My question is, does preexisting facia integrity impact outcome? I want to be able to do push-ups, pull-ups, crunches, etc. currently my abs are 3-4 fingers when upright. I can get them to 0.5 finger width when engaged. The facia is lumpy like there are multiple small tears? I’ve had some fatty tissue herniate once but it went back in easily. Does any of this matter? Or do you just sew the muscles together so it doesn’t matter?

Gary M. Horndeski, MD · Answer

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.

Connie Hiers, MD, FACS · Answer

Fascia is not lumpy so you may be feeling areas of fat. Weaken fascia can be strengthened with mesh if needed. Your surgeon who examines you will be able to tell what you can reasonably expect with a tummy tuck.

Camille Cash, MD · Answer

The concerns that you describe with muscle wall separation are actually what makes the tummy tuck such a powerful operation.  During this procedure your surgeon will be able to correct your abdominal wall laxity.  Mesh reinforcement can be used if necessary.  Once healed you will be able to return to your regular exercise regimen including dedicated abdominal exercises. When you are ready be sure to visit with a board certified plastic surgeon for a consultation.

Mats Hagstrom, MD (license on probation) · Answer

Weakness in abdominal midline fascia will be corrected automatically with appropriate muscle tightening during a full tummy tuck.
As long as your hernia was small, and in the midline, it should be corrected automatically simply doing the procedure correctly.
I suggest having multiple in person, consultations with local, board-certified plastic surgeons in your community. During the consultation, bring up your medical history, including your description of facial weakness and potential ventral hernias.
During each consultation, ask each provider to open up their portfolio and show you their entire collection of before, and after pictures of previous patients who had similar body characteristics to your own. And experience plastic surgeon should have no difficulty showing you the before and after pictures of at least 50 previous patients. Pay close attention to each providers typical results focusing on who gets the most natural looking belly button with a very low set scar that follows anatomic contours naturally and evenly on both sides, leaving the torso looking, balanced, appropriate and attracted from all angles, including from behind.
There’s no correct number of consultations needed to find the right provider. Expect there to be a significant difference in style and approach, skill and experience among each provider. The more consultations you scheduled the more likely you are to find the best provider.
For permanent irreversible body contouring procedures, I suggest patients consider having five consultations before scheduling surgery.
Best,
Mats Hagstrom, MD

James Hoyt, MD (retired) · Answer

Yes, the integrity of fascia is crucial in tummy tuck procedures. Maintaining proper fascial support contributes to a more stable and satisfactory outcome, helping achieve a natural-looking result and preventing complications like bulging or contour irregularities.

Kamil Manav, MD - Account Suspended · Answer

Hello, you are ideal patient for tummy tuck surgery. You have sagging and laxity skin. In the surgery your tummy wall push down and your muscle repair inside so the fascia integrity is done. Therefore after the surgery your tummy looks more flat. It does not matter you have fatty hernia. I will repair at he same time.

Does the integrity of fascia impact the tummy tuck outcome?

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