How Are the Muscles Tightened in a Tummy Tuck?

After the tummy tuck, will the muscles respond better to exercise?

Doctor Answers 14

Tightening muscles with a Tummy Tuck

I'm going to try to answer this question with as little doctor-speak as possible. When you gain and lose a lot of weight or go through pregnancy your tummy gets stretched out and then relaxes back down. The muscles of your tummy also stretch out. The main muscles we are talking about are two big muscles that run up and down in the middle of your tummy. They are called the rectus abdominus muscles. They are supposed to be side by side like two columns right next to each other. With weight gain and/or pregnancy they can stretch out in the up and down direction as well as pull apart in the middle, separating from side to side. It is the side to side separation that is the real problem.

The splitting apart of the muscles is called diastasis recti. This separation is the cause of the poochy shape of the lower tummy after pregnancy. Here ls the main problem: you can exercise the muscles to make them strong again in the up and down direction, but there is no natural way to firm things up again from side to side. There is no way to exercise your muscles in a sideways direction. 

A tummy tuck can bring those muscles back to the middle where they belong but pulling them into position and keeping them there with stitches. When they are separated they are a bit weaker than they should be. This is due to the physics of how they work. They are meant to be together in the middle, so when they are put back that way they probably work a little better. You might not notice a big improvement when doing exercise, but some patients do feel stronger and more stable.

I hope this info helps!

Miami Plastic Surgeon
4.9 out of 5 stars 20 reviews

Muscle tightening during tummy tuck

Abdominal wall tightening (muscle plication) is performed routinely during  a tummy tuck procedure. This is basiclally done by using permanent stitches and forming a pleat, like a tailor would do when taking in a shirt, which runs vertically from the pubic bone up to the sternum (breast bone). This creates a flat appearing abdomen by relocating the abdominal muscles back into their original position. Pregnancy, aging and weight fluctuations can weaken these muscles.

Discuss this in further detail during your consultation with a board certified plastic surgeon.

Best wishes,


William Bruno, MD
Beverly Hills Plastic Surgeon
4.9 out of 5 stars 376 reviews

After the tummy tuck, will my muscles respond to exercise better?

Pregnancy and child birth, the ability to expand a uterus to a full term is associated with a progressive unrelenting distention and stretching not only of the uterus but of everything in its path. You cannot have skin stretch marks without having previously stretched and split, to a varying degree, the tummy muscles. As a result, to RESTORE the tummy to its pre-baby(ies) look, if not better, the muscles MUST be "taken in" to the size AND location they wetre in before the pregnancy(ies). Plastic surgeon differ in how and how much they thighten the tummy muscles but failure or avoidance of tightening the muscles in a mother is, in my opion, a surgical mistake; one which would fail to deliver the flat tummy with an narrow hourglass waist all women want to get back. 

Peter A. Aldea, MD
Memphis Plastic Surgeon
4.9 out of 5 stars 109 reviews

Muscles tightening with abdominoplasty

The muscles are not really "tightened".  The rectus muscles (six-pack muscles) are brought closer together in the midline by stitching the fascia that envelops them.  Muscles themselves don't hold stitches very well but fascia is a strong as packing tape and it sort of looks like packing tape. 

Lisa Lynn Sowder, MD
Seattle Plastic Surgeon
5.0 out of 5 stars 73 reviews

Repair of muscle separation can help core muscle strength

The stretching forces of pregnancy can cause the rectus abdominis muscles to pull apart from each other.  This is called rectus diastasis.  When this happens, the position of all the muscles of the abdominal wall shift out of position, upsetting the balance of your "core" or abdominal wall and back.  Tightening the connective tissue between the rectus muscles, to pull both muscles back into the middle so they are right up against each other, restores the proper postioning of all the core muscles.  Abdominal exercises become more efficient and effective after tummy tuck with repair of the rectus diastasis

Elizabeth Slass Lee, MD
Bay Area Plastic Surgeon
4.9 out of 5 stars 54 reviews

Muscle repair with tummy tuck

The muscles of the abdomen like all parts of the body are encased in a fibrous envelope (fascia), so the muscle repair actually involves stitches into the fascia. This is necessary because the muscles often get pushed apart with pregnancy, but the direction of muscle contraction doesn't pull them together with exercise. Muscle tone is always a matter of exercise so the results of working out after tummy tuck may look better than without but the surgery won't make the muscles stronger.

Richard Baxter, MD
Seattle Plastic Surgeon
4.9 out of 5 stars 53 reviews

How Are the Muscles Tightened in a Tummy Tuck?

You have asked 2 different questions in my reading of your posting. One is technical, in that, the method of recti plication is that issue. Each doc has their methods of suture, incisional, mesh plication. As gfor the second issue of better muscle response after TT. I know of no studies showing or responding to this issue. 

Darryl J. Blinski, MD
Miami Plastic Surgeon
4.6 out of 5 stars 174 reviews

Vertical & Horizontal Tightening of the Muscles

Expansion of the abdomen following pregnancy of excessive weight gain & subsequent loss will cause separation of the muscles away from the midline.  Muscle tightening involves in approximating the separated muscles and sawing them in the midline.  If there is horizontal laxity of the muscles, horizontal tightening of the tissues covering the muscles will result in tighter and flatter abdomen and significantly improved waistline.  After adequate healing of minimum 2 months you can resume general fitness exercises to stay in shape.  Best of luck!

Ivan Thomas, MD (retired)
Los Angeles Plastic Surgeon
4.7 out of 5 stars 13 reviews

5 important points about tightening muscles in a Tummy Tuck

5.  the Rectus Abdomini (your six pack) that was stretched with pregnancy or weight gain if you haven't obviously been pregnant.  It needs to be tightened.

4. The muscles are not cut, but are "Imbricated" (folded centrally and sewed to tighten) in a "north-to-south" position.  

3.  If you are a  "massive weight loss" patient (classified as greater than 70 pounds) you may also have an imbrication in the "east-to-west" position as well.

2.  Be careful about procedures which are marketed as "less painful" or faster recovery without doing a muscle tightening as you may be dissatisfied with the bulge after surgery.

1. Make sure you feel comfortable with your surgeon and that he or she has tons of great B&A's (before and after photos) to show you.  

Douglas S. Steinbrech, MD
New York Plastic Surgeon
4.9 out of 5 stars 40 reviews

Tightening of abdominal muscles with a tummy tuck

The fascia which surround your abdominal muscles are usually tightened with a series of sutures horizontally. The degree of tightening and the suture type may vary but one attempts to not actually injure the muscles themselves. After post op healing is complete you can work on strengthening your abs more. Best wishes

Craig Harrison, MD, PA
Tyler Plastic Surgeon
5.0 out of 5 stars 32 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.