Possible to Fix Baggy Stomach Skin Without Muscle Repair?

I have abdominal separation and umibilical hernia, but I am more concerned about baggy skin on my stomach. I want it removed without getting my muscles fixed to decrease my down time. Is this possible? Would it be worth it?

Doctor Answers 8

Fixing Loose Abdominal Skin Without Fixing The Muscle

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Based on the photograph you appear to be an excellent candidate for a tummy tuck procedure. A tummy tuck allows the surgeon to remove the loose, hanging skin, repair the muscle (and hernia if present) and perform liposuction to finely contour the abdominal region.

If you choose to address only the 'baggy' skin and not correct the muscle bulging I strongly believe that you are getting a suboptimal result. You may be left with abdominal skin that appears more taut, however, you will still have a protuberatnt (bulging) abdomen that will detract from your result. I would encourage you to defer your procedure until you have adequate time to recover from a traditional tummy tuck procedure which will also correct the muscle separation (and umbilical hernia).

Remember, the goal of a tummy tuck procedure is to provide you with an attractive abdominal contour that looks nice both with and without clothing.


Palm Beach Plastic Surgeon
4.9 out of 5 stars 58 reviews

Tummy tuck without muscle repair

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Although it would be possible for you to have a tummy tuck with skin removal only, your results would be underwhelming. From your picture, it's readily apparent that you have significant laxity of the midline abominal wall muscles. This is the major contributing factor to the bulging of your abominal wall. Removal of skin without tightening this layer would result in only minor differences in appearance.

So, although it is possible for you to have a skin-only tummy tuck, it would almost certainly not be worth the expense involved.

Tummy tuck without muscle repair

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I would not recommend that just by looking at your photos. Yes you do have a lot of loose skin and stretch marks and would have good results just by removing the skin, but you will still have the bulge and will likely be disappointed with your results. If you are investing the money and the risk of the surgery, I would recommend getting it done RIGHT and having done what needs to be. Yes you would need to set a side about 2 weeks time for the surgery and down time.

Good luck.

Farbod Esmailian, MD
Orange County Plastic Surgeon
5.0 out of 5 stars 88 reviews

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Tummy Tuck without Muscle Repair

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Tummy Tuck (Abdominoplasty) is an operation designed to improve the contour and shape of the abdomen. Often pregnancy or significant weight gain can stretch not only the skin of the abdomen but also the muscle layer as well. A typical abdominoplasty not only removes the excess skin but also tightens the abdominal wall in those cases when it is necessary. Commonly, we perform some limited liposuction of the abdomen along with the abdominoplasty to further improve the contour and ensure that there is smooth transition from the abdominal flap that has been brought down to the pubic area along the incision line.

Muscle tightening is sometimes not necessary if there has been no significant muscle stretch and the patient has exercised and redeveloped good abdominal muscle tone. Unfortunately, in many cases there has been some stretch of the linea alba. This is a strip of nonmuscle containing tissue that runs down the midline from the bottom of the breastbone to the top of the pubic bone. It runs between the two rectus muscles that comprise the “six-pack” seen on body builders. Similarly to skin, there is no amount of exercise that will tighten the linea alba. Thus the only choice here is to surgically tighten (plicate) this layer during an abdominoplasty.

Tightening of the abdominal muscle layer also allows the surgeon to correct any abdominal wall defects such a hernia. This is a valuable procedure in that hernias may enlarge with time and more importantly a hernia may lead to a serious surgical (and possibly life threatening) emergency if the intestines become trapped in the hernia sac.

I would recommend that you go ahead and have the muscle layer repaired in the situation described here. First, the hernia should be addressed for the reasons cited above. Secondly, skipping this step will significantly reduce the quality of the result that you will get from a tummy tuck. Muscle tightening will flatten the stomach giving a very aesthetic result. Tightening the muscle layer offers no significant increase in surgical risk or complications and you still will need to recover from the surgery with or without muscle tightening. I wouldn’t let the modest increase in recovery from the muscle tightening sway me away from having it done. You’ll get a much better result and I think that in the long run you’ll be much happier with your surgery instead of opting for a half result.

Alexander G. Nein, MD, MS, FACS
Nashville Plastic Surgeon

Results Wouldn't Be Optimal... Full Tummy Tuck Recommended

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It’s definitely possible to perform an abdominoplasty without tightening the underlying muscles.When patients have loose abdominal skin and tight underlying muscles there’s really no reason to tighten the muscles.Unfortunately this situation is rare and most patients need their muscles tightened.
Your pictures suggest the presence of loose saggy skin, weakened abdominal muscles, excess fat and stretch marks.Correction of this type of problem requires a full abdominoplasty. Although this procedure could be performed without tightening the muscles, the result would be less than optimal.Under these circumstances, clinical results and satisfaction rates would be adversely affected.
The best results are obtained when correct analysis is performed and the best surgical option is applied.For these reasons, it’s appropriate to consult a board certified plastic surgeon with experience in this area.This surgeon should be able to formulate a treatment plan that addresses your anatomic findings and achieves your aesthetic goals.

Have the right surgery for baggy stomach skin

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If you are getting a tummy tuck and the doctor does the correct operation, fixing the muscles will need to be done. It appears as if you have a SIGNIGICANT diastasis of the recti muscles. Get them repaired, in order to remove all the excess skin you have, you surgeon will be right there. Look at some of my photos and see how flat the stomach can be after a tummy tuck, if you only have the skin excised, you may still have a protruding abdomen.

William B. Rosenblatt, MD
New York Plastic Surgeon
4.2 out of 5 stars 12 reviews

Muscle repair with tummy tuck is usually best

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The most common reason for doing tummy tucks is prior pregnancy, which causes stretching of the skin and pushes the muscles apart (called a diastasis.) Because the muscles contract in a vertical direction, no amount of exercise will pull them back together when they are separated laterally. For this reason, it is usually a good idea to correct the problem when doing a tummy tuck. The disadvantage is that it makes the recovery longer, since it is analogous to doing a hernia repair. Every case is different, but my guess is that you will be happier in the long run if youhave the muscle repair.

Richard Baxter, MD
Seattle Plastic Surgeon
4.9 out of 5 stars 59 reviews

Abdominoplasty without muscle repair

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I think if you declined the muscle repair in the course of your abdominoplasty you would be short changing yourself. The benefit of the muscle repair performed during the course of the abdominoplasty outweighs the small potential increase in recovery timeIn the performance of a full abdominoplasty, an incision is made from one hip to the other. The incision is carried through the skin and fat layer and stops at the muscle layer. At this level the skin and fat layer is elevated off of the underlying muscle layer. This elevation is continued up to the belly button. An incision is then made around the belly button to keep it in it's normal location allowing the skin and fat layer to continue to be elevated up to the rib margin. Very often tightening of the muscle layer is then accomplished before removing the excess skin. The loose skin and fat layer is then pulled down snugly and the excess skin and fat is then removed. The belly button has not been moved or removed. It is still in it's normal location underneath the skin and fat layer. An incision is made over the belly button and it is pulled up to the surface and re-stitched in it's original location.
By this description I hope you can see that the majority of your recovery is in the other components of the abdominoplasty.
My simple and illustrated video may help you--learn more about tummy tucks and other body contouring procedures.

John J. Edney, MD
Omaha Plastic Surgeon
4.8 out of 5 stars 133 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.