Tummy Tuck Without Much Muscle Work?

Is it possible to have a Tummy Tuck without having to do a lot of muscle work, and just remove the extra fat? Liposuction is not an option for me because I'm too old (I'm 62) and my skin isn't as tight anymore.

Doctor Answers 6

Tummy tuck without muscle work

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Of course it is possible to perform a tummy tuck without tightening the fascia (the lining of the muscle), but why?

One of the best parts of the tummy tuck is the ability to tighten the fascia, making the abdominal bulge much better. The muscle bulge results both from childbirth and from menopause.

For patients concerned with postoperative pain, we use pain pumps. All tummy tuck patients go to Aftercare, where an RN is there to administer pain medication if it is needed.

So to defer the muscle tightening because of a fear of pain, should no longer be necessary.

There are few women who are 62 years old and have looseness of the skin that wouldn't also benefit from muscle tightening.

Beverly Hills Plastic Surgeon
4.9 out of 5 stars 188 reviews

Tummy tuck without muscle tightening

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Hi, thanks for posting your question.  Abdominoplasty without fascial tightening is a valid procedure for a small subset of the population.  The questions that I would like to have answered are:  1.  Have you had any children?  2.  Has your weight been stable your entire adult life?  3.  Do you have any concerns about tightening your abdominal wall?  The first two questions deal with what degree of laxity you have about your rectus muscles.  With pregnancy and/or extreme weight fluctuations, you will stretch this area out and in order to appropriately contour your midsection, you will need fascial plication.  The last question deals with, any apprehensions that you may have in regards to the wall tightening procedure.  Are you concerned with prolonged recovery and pain?  I hope this helps

Tummy Tuck results may not be as tight without muscle work

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You can choose not to have a muscle repair during tummy tuck, but your results won't be nearly as tight. As long as this is acceptable to you, you should be OK.

John P. Di Saia, MD
Orange Plastic Surgeon

Tummy Tuck is like a Chinese menu

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One from column A, One from Column B. For those in the know, the chinese menu offers many options in an effort to satisfy the hungry soul. Plastic surgery is not all that different. Not all patients have the same goals, pre-existing problems or conditions.

The abdomen has several different issues and necessary treatment options:

1. Excess skin - only treatment is surgical excision. Elasticity is not altered with this procedure.

2. Excess fat - liposuction or surgical excision is ideal. Diet can remove the excess fat but will not change the contour.

3. Weakened or stretched abdominal wall muscles - plication of the muscles during surgery. Non-surgical approaches like pilates do have some merit.

You can have all, some or none of these techniques within the course of your surgery. You choose, but make sure you have the advice of an honest, reputable plastic surgeon to make sure that your goals are satisfied by the procedures chosen.

Abdominoplasty is a generic term

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Generally speaking, cosmetic surgery is applied anatomy and one shouldn't get tied down to labeling of procedures. For example, abdominoplasty does not explain what is done specifically and one abdominoplasty may be entirely different from another.
Just because you are having something called an abdominoplasty, it doesn't mean you have to have everything done that is described in an abdominoplasty.

I look at each component of the anatomy to determine why you look the way you do. It may be too much skin, poor quality skin, too much fat, not enough fat, poor quality muscle, displaced muscle, intra-abdominal contents and fat, and even muscle tone and posture. In fact, posture is often ignored and may contribute the most to one's contour.I try to assess the resting tone of muscle and the normal posture of a patient to determine how much an affect the muscles have on your contour.Coupled with what you desire out of the procedure this would determine if muscle tightening is warranted or benefical, where the muscle tightening should occur, how it should be done,and what risks there are. Excessive muscle tightening especially when not beneficial can cause more pain, increased intra-abdominal pressure, difficulty breathing post-op, and increased risk of deep vein thrombosis. You are right to question the need for muscle tightening as I feel that is it often unnecessary or ineffective. I suspect that you would be happy even if you weren't the thinnest and tightest you could be.

Robin T.W. Yuan, MD
Beverly Hills Plastic Surgeon

Possible, but not necessarily advisable

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Tummy tucks, or abdominoplasties, remove excess skin and the underlying fat from the lower abdomen between the belly button and pubic area. In order to close the wound and bring the skin edges together, the upper abdominal skin is released from its attachments to the abdominal muscle, allowing the surgeon to see the entire length of the rectus abdominis, or sit-up muscles.

Since laxity in these rectus muscles may occur after pregnancies, we surgeons often find that the rectus muscles are displaced to either side. In other words, instead of running vertically, like the slats of a picket fence, they may bow outwards, like a pair of parentheses.

By suturing these muscles together to pull them back to the midline, we can tighten you from side to side and accentuate your waistline by narrowing it. Since we have the exposure already, it makes sense to do this at the time of the skin and fat removal. The discomfort of the muscle tightening can be controlled with pain medications or a pain pump.

The improvement achieved with muscle tightening, in my opinion, outweighs the temporary slight additional discomfort. I would ask you to please reconsider your stance on this. Good Luck!

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.