Does Tightening of Abdominal Wall During Abdominoplasty Alter Results?

I am scheduled for a full Tummy Tuck in 3 weeks and am wondering if tightening the abdominal muscles dramatically affect the visible results. I have had 2 children and have lax saggy skin but I only have slight separation of my abdominal muscles near my belly button.

If I don't get my muscles tightened will my recovery be quicker? Will not tightening the muscles be a regrettable decision?

Doctor Answers 9

Tightening the muscles is a necessary part of a tummy tuck

Only in men with massive weight loss would I consider not tightening the muscles.  When a patient has had children the muscles virtually always need tightening.  If you don't do it you won't get the flattest tummy you could have had and you will regret that. 

Seattle Plastic Surgeon
4.8 out of 5 stars 67 reviews

Muscle tightening in abdominoplasty

Fascial tightening with a tummy tuck markedly improves the results.  It makes the waist narrower and reduces the tendency toward a bloated or pregnant appearing lower abdomen that women notice so commonly after pregnancy or after the start of menopause.

Brent Moelleken, MD
Beverly Hills Plastic Surgeon
4.9 out of 5 stars 177 reviews

Muscle tightening not always necessary in abdominoplasty

In most cases, plication or tightening of the rectus muscles will improve the results, but not in all patients.

In heavier patients without significant muscle diastasis (muscle separation), the improvement resulting from muscle tightening in small. However, it is still usually performed because the increased discomfort from muscle tightening is also small.

Discuss with your doctor the pros and cons of each. Good luck.

Dean Fardo, MD
Atlanta Plastic Surgeon
4.6 out of 5 stars 13 reviews

Abdominal wall tightening makes a big difference

Hi Stacy,

In most women, tightening the abdominal wall muscles is as important as removing the extra saggy skin. Although you may only have minimal muscle separation, the bulging of your abdominal wall is the result of generalized looseness of the abdominal muscles. Failure to tighten this layer will prevent optimal correction of your bulging.

Without a doubt, your recovery would be faster without abdominal wall plication. Unfortunately, your results probably won't be as good.

Hope this helps. Best of luck.

Sam Jejurikar, MD
Dallas Plastic Surgeon
4.9 out of 5 stars 92 reviews

Results of Tummy Tuck and Muscle Tightening

Muscle tightening is CRUCIAL to a good Tummy Tuck result. Without it, while your recovery would be quicker by about a week, your results will be disappointing.

Why would you need to have your muscles tightened? Think for a second what your 2 pregnancies did to your abdominal wall. Basically, envision your favorite blouse worn by a football line backer for 9 months, returned back and then worn again by another. Was only the front stretched out? Did only a few buttons pop out? Would the blouse fit you again REGARDLESS of all the exercising, massages or washings? - Of course NOT. The actual fabric and seams were stretched out.

In the case of a Tummy Tuck, the muscle repair allows us to "take in" the loose abdominal wall to make up for a stretched out muscle wall. Without doing so the results will NOT be as tight as they could be.

Dr. P. Aldea

Peter A. Aldea, MD
Memphis Plastic Surgeon
4.9 out of 5 stars 108 reviews

Tightening the abs with a tummy tuck

Even if there is a slight separation, I believe that bringing the muscles together tightly in the midline improves results. Think of it as a more solid foundation for the skin. It does lengthen the recovery process in terms of activities such as lifting and exercise, but it is worth it most of the time.

Richard Baxter, MD
Seattle Plastic Surgeon
4.9 out of 5 stars 52 reviews

Abdominal muscles in abdominoplasty

The abdominal muscles have a great deal to do with your end result. However, it is not always a function of surgery.

First, the muscles have to be innervated normally. Some muscles might be flaccid due to de-nervation or stretching of the muscles. This does not sound like your situation.

Second, the muscles need to be in proper relationship to function optimally. If they are widely separated, their function is suboptimal. Here is where a surgical tightening can help.

Finally, there is the factor of muscle tone. Normal patients with normal musculature might have poor muscle tone (i.e. posture). This might be due to lack of exercise or due to habit.

A careful exam and testing can discern what factors are present in your situation. Almost all patients should try to achieve optimal toning and strength by exercising and also improved posture.

Robin T.W. Yuan, MD
Beverly Hills Plastic Surgeon
5.0 out of 5 stars 11 reviews

Tightening of the abdominal wall sets the foundation for a good abdominoplasty

I think you would get a satisfactory result with a standard abdominoplasty and diastasis recti repair. The fascial or muscle repair sets the foundation for the abdomen.  If you have a prominent muscle bulge then yes it will be best to correct this at the same time.  The skin will be removed in an elliptical pattern from the umbilicus to a point just above the pubic bone.  The stretch marks above the umbilicus will look better when the skin is stretched tight but the will not be removed just lowered down.   There is always a possibility of making a bad scar but attention to detail and using standard plastic surgical techniques can keep this to a minimum.

Jeffrey Zwiren, MD
Atlanta Plastic Surgeon
4.5 out of 5 stars 19 reviews

Tightening the muscles generally improves the result for a tummy tuck

The best person to answer this question is your surgeon.  I find that patients that do a lot of strenuous abdominal exercises before having an abdominoplasty can skip the muscle portion of the procedure and still get excellent results.  This is, however, a distinct minority of abdominoplasty patients; not your average tummy tuck patient.  Ask your surgeon if he or she thinks that you could avoid the muscle repair without hurting your end result. Sometimes the surgeon can decide in the operating room with the muscles exposed whether or not to perform the muscle plication. Avoiding the muscle repair does reduce pain and can shorten your recovery but it may be at the price of not having as flat of a tummy as you would like.

James McMahan, MD
Columbus Plastic Surgeon
4.8 out of 5 stars 38 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.