Tummy tuck, making the waist even smaller?

Thanks for your question. Yes it is possible to bring in the waist some more by not only bringing your "muscles" (rectus abdominus muscles) together in the mid-line, but I also frequently put a row of sutures along the lateral (out edge) of the rectus abdominus muscles which further draws in the flanks. The only downside it can slow down your recovery, as these extra muscle stitches can mean that the tummy remains sorer for a few weeks longer than normal.

I think that your best result would come from liposuction of the waist and the tummy tuck.   If the waist was smaller at one time, the waist can likely be reduced to those same measurements or smaller provided the muscular and fascial integrity has remained the same.Kenneth Hughes, MD, Board Certified Plastic SurgeonLos Angeles, CA

It is possible to sew not only the midline of the Rectus abdominis muscle but also at its lateral borders. This will bring the flanks closer to the midline thus decreasing your waistline. However, more stitches mean longer recovery time and the swelling and bruising could last for more than a few weeks as compared to stitches on the midline alone. Schedule an appointment with a board-certified plastic surgeon of your choice for an in-person examination.

Yes, there is some "leeway" when it comes to how much the abdominal wall muscles can be "tightened" during tummy tuck surgery. Of course, care was taken to avoid too much tightening that may cause problems such as abdominal wall pain, respiratory compromise, gastroesophageal reflux… Sometimes, depending on the patient's anatomy, plication of the oblique muscles may also help when it comes to achieving a "smaller" waistline. Also, liposuction (if adipose tissue is part of the patient's concerns) may be helpful when it comes to achieving the waistline improvement. Ultimately, careful selection of plastic surgeon and careful communication of concern/goals will be key. Best wishes.

Hi MummaS89,Thanks for your question. It is possible to change the size of a waist during a tummy tuck. There are different ways to tighten the muscles and different areas will stretch differently. It is well worth discussing this with your surgeon who will be able to examine your stomach to give you an idea of what could be done.Hope this helps.

Hi
You will not see a significant difference by over-tightening the rectus muscle separation and is something I would not recommend.
Waist-definition is dependent on a number of factors including intra-abdominal volume, thickness of subcutaneous fat, abdominal muscle laxity, ribcage and pelvic anatomy. 
For selected tummy tuck patients, to enhance the waistline and overall appearance, I perform comprehensive liposuction of the abdomen. This combined with tightening of the fascial layer beneath the skin and muscle tightening produces an optimal result.
All the best!

The muscles can be sutured in the midline or at the edges or both. The limiting factor that dictates the amount of tightening is the pressure that this tightening exerts on the intra abdominal contents and hence on the lungs. Just be careful in this as it might lead to difficulty in breathing and in extreme cases to pulmonary failure.
Best, 
Shady Hayek