I Had a Tummy Tuck and my Doctor Did Not Stitch my Muscles, Is That Normal?

Doctor Answers 9

Tummy Tuck

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If your doctor was a Board Certified Plastic Surgeon then he/she would have stitched or tightened the abdominal muscles if indicated.  Ask your surgeon why they were not stitched.  Not all abdomens need to have the muscle stitched.  Pregnancy will have a higher risk of muscle separation, and need of muscle tightening.

Repairing muscles during tummy tuck

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We almost always repair the muscles, that is, do a fascial plication to tighten the abdominal wall fascia and muscles to get a tighter, flatter tummy.  On occasion I have treated a patient who has loose skin but no fascial laxity or diastasis recti (muscle separation), and in those cases I have not repaired the muscles.  Certainly the muscle repair is the most painful part of the tummy tuck.  A patient whose complaint is in regard to the loose skin only and who would like to avoid the muscle repair can do so.  However, most patients want the most improvement if they are going through this significant surgery, so it is not as common to leave the muscles unrepaired.  Again, I would assume that you and the surgeon discussed this at the preoperative consultation and pre-op appointment.

Muscle plication with a TT

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I rountinely do a muscle plication when doing a full TT.  If the patent requests that it not be done or I thnk it is not needed I have that discussion before surgery.  Ask your surgeon why he/she chose not to do it.

Tightening muscles in a tummy tuck

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The intraoperative decision is made by the doctor and they must have judged that you didn't need it.  Hopefully you went to a real plastic surgeon so at least it wasn't as if they didn't know how to do it and "decided not to."

In my practice, a few weight loss patients and males might not need muscle tightening but I do some on all the rest, about 99% of my TT's, and I do lots of them.

Stitching muscles with tummy tuck

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It is often necessary to bring the rectus muscles together if they are splayed apart following pregnancy or weight loss, however it is not always needed.  If you have a bulge between your six pack muscles when you do a straight leg raise while lying on your back, then your rectus muscles are diverged and need repair.  Not everyone has this divergence of the muscle and so not every needs them to be stitched back.  Stitching the muscles is painful and can bring with it potential complications and so should not be done unless it is required.

Are you happy with your result?  If so - don't worry about whether the muscles were sutured or not. 

Question before surgery

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This hould have been addressed prior to surgery in your consuktation and as part of informed consent.  I would follow-up with your PS and find out why this was not done.

Diastasis Repair during Abdominoplasty

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Rectus diastasis reapir (stitching of the muscles) is common during abdominoplasty.  Hopefully you had a discussion with your surgeon prior to surgery and the plan that you had agreed upon was followed.  Based on my practice, there have only been a few patients out of hundreds that did not require muscle tightening during the abdominoplasty and I had discussed that with the patient before the surgery.  I would suggest discussing your concerns with your surgeon.


Good Luck.

Separation of the muscle (diastasis) is treated by suturing the muscles

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Separation of the muscle (diastasis) is treated by suturing the muscles during abdominoplasty.  However not all patients have this problem.  If you are dissatisfied with your results you might consider rediscussing this with your treating surgeon or seeking the opinion of another a board certified plastic surgeon.

Tightening the muscles during tummy tuck

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The abdominal muscles are often separated by pregnancy or significant weight gain so they are frequently tightened during an abdominoplasty.  However, there are some people that do not need it because their muscles are fine and in the normal anatomic position during the time of surgery.  Most plastic surgeons do it routinely on everyone who needs it. That should be one of the questions you ask before surgery.   If your doctor does not routinely stitch the muscles, you should seek a second opinion from another plastic surgeon.

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.