TT Without MR, Are the Results Worth it?

Question

I understand that a TT with MR is how to get the best results, but is it possible to be a candidate who does not require MR during the TT? Are the results worth it?

J. Jason Wendel, MD, FACS · Answer

Yes, it is possible and the results can be very good depending on the quality and tone of your abdominal wall. To be sure, see two or more board-certified plastic surgeons in your area for a full and complete evaluation to make sure you are a good candidate and that it is safe for you to have surgery. I hope this helps.

Gary M. Horndeski, MD · Answer

The goal of the TT is to improve the aesthetic appearance of the abdomen.  The aesthetic appearance is determined by two factors, skin and fasica NOT muscle.  After pregnancies or weight gain, the fascia undergoes stretching.  At the time of the TT, the fascia should be repaired.  This can be done in the midline and in the flanks to create a more hour-glass figure.  Also, the fascia can be augmented by mesh.  I routinely perform TT with mesh reinforcement and have published articles on this.

	Besh of Luck,

	Gary Horndeski, M.D.

Ralph R. Garramone, MD · Answer

In my opinion, the muscle repair is not an option part of a tummy tuck but an integral part of the procedure responsible for a significant portion of the result.

	The majority of patient having a tummy tuck have had 2 or more pregnancies and the muscle-fascia layer has been stretched and weakened and accounts for the rounded appearance of the abdomen after pregnancies compared to the flatter appearance of the abdomen before pregnancies.

	To have the rest of the procedure and leave out one important part really doesn't make sense to me since the flatter appearance after a tummy tuck is what most patients like most.

	Thank you for your question and best of luck.

Tom J. Pousti, MD · Answer

Thank you for the question.

	One of the steps of a tummy tuck procedure involves reapproximation (plication)  of the rectus muscles.  These muscles have spread apart during pregnancy and/or weight gain. Bringing them together again in the midline helps to &ldquo;tighten&rdquo; the abdominal wall as well as to narrow the waistline.

	Occasionally,   a patient will present with excess skin and adipose tissue but without  separation of the abdominal wall muscles.  For this ( unusual)  patient a tummy tuck without muscle repair may well be &ldquo;worth it&rdquo;. Unfortunately, most &ldquo;mommies2four"  do have muscle separation and benefit from the muscle plication portion of the procedure.

	In person examination will be necessary for precise diagnosis and recommendations.

	I hope this helps.

Peter A. Aldea, MD · Answer

The short answer is: It depends.

	Consider for a second WHY you are having a Tummy Tuck in the first place. It is usually to get rid of excess abdominal skin caused by either weight loss or pregnancy.  In BOTH processes the abdomen expanded permanently stretching out EVERYTHING in front of it, muscles and skin. The skin could not have stretched if it was not pushed forward to the point of cracking (Stretch Marks) were it not for the muscles being stretched and split.

	It is a rare to see a woman with excess abdominal skin who does not have stretched and even split six pack muscles. If you are in this group then foregoing the muscle repair may work out. In the majority of people, failing to tighten the muscles always results in a poochy, ugly result which was already paid with a long transverse scar. In other words, in them failing to repair the muscle is a missed opportunity for a MUCH more attractive result.

	Peter A Aldea, MD

Richard P. Rand, MD, FACS (retired) · Answer

Muscle tightening is a routine part of a tummy tuck in 90+% of patients having a TT. Only those who are weight loss patients without kids make up most of the remaining 10%. The muscle repair is safe and easy to do, just hurts a little longer but it is the way to the best and flattest result.

TT Without MR, Are the Results Worth it?

Answers (6)

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