Surgical Procedures for Extremely Lax Abdominal Wall?

I had High Lateral Tension Abdominoplasty. I had a large bulge in my lower abdomen.I had minimal skin laxity and had no extra fat. An ultrasound scan has shown my internal organs are fine.I do not have a hernia. It showed that my rectus muscle is now very tight and the surrounding muscle is well developed. What it did show is that my abdominal wall is still loose and falls forward when I stand up. What can be done for me? Please help. I had a flat tummy before having children so this is not the natural state for my body.

Doctor Answers 2

Loose skin after abdominoplasty

You don't mention how tight the ski was right after the procedure, how long ago the procedure was done, and if there has been any changes in your weight or have had children since the original surgery. All these play a factor and should be discussed either with your original surgeon or with a new board-certified plastic surgeon. The internet can only answer so many questions and is no substitute for a good exam and evaluation. It sounds like you are asking the right questions. Good luck.

Frankfort Plastic Surgeon
4.7 out of 5 stars 15 reviews

Recurrent or residual laxity can be fixed with revision Tummy Tuck

The high lateral tension abdominoplasty was pioneered by Dr. Ted Lockwood and was quite popular about 10 years ago. Basically, the "tension" is greater on the "lateral limbs" of the incision, the concept being to lessen the tension centrally. The main thing I don't like about that particular technique is that the lateral "limbs" of the incision typically come upward at a higher angle and are more visible in current clothing attire, swimsuits, etc. I have had several patients that wanted me to revise the incisions or "lower it," and unfortunately, that is not possible.

It is impossible to know why, but you have either residual or recurrent abdominal wall laxity (medical term is rectus diastasis). Sometimes, when it is flat and then suddenly changes, the "plication" suture or sutures may have broken. This can happen in the post-operative period with straining or coughing, or sometimes it just happens. It could also have stretched out over time for a variety of reasons.

I agree with a CT scan to rule out a hernia and also rule out a chronic encapsulated seroma which sometimes can be present.

The solution is to perform a "revision abdominoplasty" (revision tummy tuck) and utilize the same incision and re-tighted the lower abdominal wall. The good news is likely the incision around the belly button or navel will not need to be re-created since this problem seems to be in the lower abdomen.

I hope this helps!

James F. Boynton, MD, FACS
Houston Plastic Surgeon
4.8 out of 5 stars 42 reviews

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