How to Fix Too Tight Tummy Tuck?

Question

It has been 3 years since my tummy tuck...I'm miserable. It is so tight that I can't wear anything but elastic. When I exercise the muscles will go into spasms. I have no waist anymore and look like I'm 3-4 months pregnant. Is there anyway to fix this???

Otto Joseph Placik, MD · Answer

I have been told by many general surgeons that the muscle tightening we perform in tummy tucks will not last.
I think you are an example of someone who proves them wrong.
This does not happen often but one of my paitents experienced similar complaints. On further questioning it was apparent that she had gained a significant amount of weight which casued the condition. Essentially, her muscle repair was too tight for her increased size. In this particular patient, I had used a mesh to reinforce the abdominal muscles after a reconstructive surgery. This would be similar to wearing a pair of jeans and gaining 20 pounds.
The muscle repair does not generally hold and should release over time if no mesh was used. This stretches out and I have seen two of my tummy tuck patients proceed to unintended but successful pregnancies.
So its important to know if you used mesh, gained weight, and what type of repair was done. IF you continue to experience significant pain the muscle repair may need to be undone.
Alternatively, there may be other explanations for your pain and you should discuss this with your surgeon. You may need diagnostic or radiologic studies to evaluate the abdomen.
I hope this helps!

J. Timothy Katzen, MD, FACS · Answer

Hello, and thank you for your question regarding the issues you're experiencing after your tummy tuck.

I’m sorry to hear about the challenges you’ve been facing. An overly tight tummy tuck can indeed lead to significant discomfort and impact your quality of life. Fortunately, there are ways to address this.

The tightness you’re experiencing might be due to the rectus abdominis muscle repair being too tight, or excessive skin tension. This can cause muscle spasms, discomfort, and a feeling of being overly restricted. Additionally, if the muscle repair was done too aggressively, it could create a bulging appearance, similar to what you described.

One possible solution is a revision surgery, where the muscle repair can be partially released to alleviate the tightness. This procedure would involve re-entering the abdominal wall and adjusting the suture lines to create a more natural, less restrictive contour. During this surgery, the skin can also be adjusted to ensure it’s not excessively tight, allowing for more comfort and mobility.

It’s crucial to consult with a board-certified plastic surgeon who has experience with revision tummy tuck surgeries. They will be able to assess your specific situation and recommend the best course of action to relieve your symptoms and restore a more comfortable and aesthetically pleasing abdominal contour.

In the meantime, it may be helpful to incorporate gentle stretching exercises and possibly seek physical therapy to help manage muscle spasms and discomfort. However, these are temporary measures, and surgical revision may be necessary to fully address the issue.

I hope this information helps, and I wish you the best as you seek to improve your situation.

Sincerely,

J. Timothy Katzen, MD, FASMBS, FICS

David Shafer, MD, FACS · Answer

Cathiee44, You really need to post a picture for us to give you specific advice. If you look pregnant, then I am not sure what you are referring to as too tight. Either the skin is too tight (which will stretch over time) and/or the muscles are too tight (which doesn't seem to be the case since you say you look pregnant). Either way, you should return to your surgeon or see another surgeon in consultation who can examine you and give you individualized advice / guidance.

York Jay Yates, MD · Answer

The natural course of recovery after a tummy tuck is for things to feel too tight for a week or two and gradually relax. Your description of spasms, loss of waist definition and fullness of the abdomen does not sound anything like a tummy tuck that is "too tight". I would recommend you see your doctor to see what is really going on.

Brent Moelleken, MD · Answer

Your best bet is to consult with board certified plastic surgeons to see what the problem is, and if a revision could help you.
Sometimes, great tightness in one area is accompanied by looseness in adjacent areas that can be recruited to release the tension in the tight area.

Steven H. Williams, MD · Answer

It sounds like you have a few different things going on here.
If you're too tight then it would be a bit unusual for you to have no waist and look like your pregnant.  
Abdominoplasty deals with excess skin and then tightening your core (your rectus muscles).  Muscle spasm may be caused by rectus plication but this usually goes away with time.  Tight skin closure usually loosens up over time.  In fact most abdominoplasties can be revised about a year afterwards.
It really sounds like your profile is part of your concern and that sounds like things may be too loose, not too tight.
I would seek a board certified plastic surgeon to perform a complete history and physical and I would bring your previous operative records.
I hope this helps.

Daniel Reichner, MD, FACS · Answer

Cathiie
It depends on where you are too "tight" - the upper muscle, lower muscle or skin layer. Your description seems to indicate that your upper muscle layer was tightened too much causing a bulge in the lower abdomen, but photographs would help. If the muscle layer is too tight, it may be possible to release some of the sutures or release the fascia to improve your results.  I recommend seeking a Board Certified Plastic Surgeon for this type of secondary abdominoplasty correction.

Kenneth R. Francis, MD, FACS · Answer

Cathie,
This is a very interesting scenario. The loss of your waistline is especially concerning.  The skin, after a tummy tuck, is almost never too tight.  It's possible that your muscle repair stitches have broken. This would cause pressure from your abdomen to be transmitted to the skin overlying it and would explain a loss of your waistline.  See your local board certified plastic surgeon for a consultation.  Good luck!

Bahram Ghaderi, MD · Answer

I agree with the other surgeon. You have had plenty of time - 3yrs - for you tissues to relax and even stretch if needed to not have a "too tight" feeling. You definitely would benefit from a comprehensive evaluation and examination by your original surgeon or a board certified plastic surgeon. I am suprised that you look pregnant but feel "too tight". If your sutures that were holding the muscle covering together have come loose and therefore put more pressure on your skin, then that may explain the tight feeling. You will likely require a revision to correct the muscle portion of the tummy tuck. good luck.

Steven Wallach, MD · Answer

It is unlclear what is exactly tight. I am assuming the muscles aren't too tight if you say you don't have a waist line. If the muscles are too tight and you get spasm, it can be very difficult to correct this presuming that you had tightening of the msucle which now has scar tissue on it. If the skin is till too tight after 3 years, it may not be wise to try to open your abdominal skin which could then be hard to close. Was there secondary healing (delayed healing) after your first procedure?

How to Fix Too Tight Tummy Tuck?

Answers (14)

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