Are There Different Techniques for Muscle Repair During a Tummy Tuck?

I had a tummy tuck with muscle repair 7 months ago. I still have a large bulge in my stomach. My PS said that I have very weak abdominal muscles. I went to get a 2nd opinion and that PS said that he would fold my muscle repair to make it tighter. My current PS pulled my muscles together and said that I don't need more done to my muscles, and I need to do crunch's. Are there different techniques for muscle repair depending on the laxiety of the patients muscles to give a flater appearance?

Doctor Answers 6

Bulge after tummy tuck - the most common reason is fat inside the abdomen

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The dirty secret about many tummy tucks where the patient has fat in their abdomen is that they will not end up flat.

The fat inside the abdomen is not treated during a tummy tuck, only the outside fascia (deep layer , "muscles") is tightened.

So doctors should be realistic with their patients about what the outcome is likely to be.  It is OK to say, "no, you will not be flat after your tummy tuck."  Then patients are not disappointed after surgery, and they trust their doctor more for their honesty.

So assuming your doctor tightened the fascia responsibly, weight loss through diet and exercise gives the best hope for a better appearing abdomen, not an alternative tightening technique.

Beverly Hills Plastic Surgeon
4.9 out of 5 stars 194 reviews

Muscle repair during tummy tuck surgery

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There are different techniques for muscle repair that can be used by surgeons during tummy tuck surgery. Any one of these techniques, however, is appropriate as long as it achieves the "tightness" of the muscle and connective tissue layers as is desired and indicated by the surgeon. A discrete bulge in one place may warrant a repair, but a general laxity is best managed conservatively, i.e. weight loss, non-smoking, good nutrition, moderate exercise under professional supervision, and close follow-up with your surgeon. As a good rule of thumb: try your hardest not to have operations on your body where you've had them before. Hope this helps. Good luck and fare well.

Daniel Kaufman, MD, MSc

Reason for Bulgng of the Tummy despite having a Full Tummy Tuck

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A well done Tummy Tuck in a well chosen woman should result in a flat tummy, narrow waist with an attractive innie belly button. Assuming you were not obese at the time of surgery, a bulge may suggest that the muscle repair was not done tightly or that itt failed resulting in recurrence.  Without an examination much less a photograph it is hard to say. 

Peter A. Aldea, MD
Memphis Plastic Surgeon

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Muscle Repair for Tummy Tuck

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Thank you for your question.  

The general technique of muscle plication is the same but surgeon's may vary things a bit. It sounds like you may benefit from additional muscle plication - but it is difficult to say without a physical examination.

Best Wishes!

Tummy Tucks and Muscle Repair

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Each surgeon has their own preference regarding muscle tightening and even if they did the same type of repair, it is dependent upon the surgical technique, judgement and experience.  Photos would be helpful but an exam is necessary to give specific recommendations.  A third opinion may be helpful.

Albert Dabbah, MD
Boca Raton Plastic Surgeon

Different muscle repair techniques for tummy tuck

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Thank you for your question. There are different muscle tightening techniques for an abdominoplasty depending in the patien's anatomy and abdominal wall laxity.Without the benefit of photos, I assume that prior to surgery when you laid down on your back, that your abdomen was flat. If this was the case, than you should have no postoperative bulges unless your sutures pulled through or the tightening was not adequate. I do this type of surgery in my office under IV sedation and epidural anesthesia. I use the epidural, because this causes good abdominal muscle relaxation and the muscles can be plicated tightly in the middline from the breast bone to the pubic bone. I do a two layer plication with dissolvable sutures (they are gone in 3-4 months) and than assess the muscle tightness. At times the lateral abdominal muscles (obliques) are loose and these need to be repaired as well to give a postoperative flat abdomen.

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.