Tummy Tuck Revision for Muscles Still Lax

Question

How soon after a full tummy tuck with muscle tightening is it safe to do revision for lax muscle?I have a tummy that looks 3-4mths pregnant. When i pull in its flat as a pancake but when pushed out its so big.  I consult a PS he says little fat under skin that not an issue. I am 5"7" 155lbs. Always working out very good and discpline eating habits so whats wrong.  My regular PS told me to wear a pair of spanx when going out.  I need a feedback please about the pros and cons of this procudure.

Andrew P. Trussler, MD · Answer

Great question. It sounds like you may have had early recurrence of your diastasis or failure of the muscle repair. The question you should ask, is if your muscles were tightened with the original tummy tuck and then with how many sutures and what kind. These sutures can fail, and it is no one fault, but it should be easily delineated and is an easy fix, though I would wait at least 6 months. Other things it could be is fluid along the abdomen (seroma) or some central fat. Your plastic surgeon should be able to let you know what is the cause.
i hope this helps

Otto Joseph Placik, MD · Answer

SEE VIDEO BELOW: It is difficult to say if this is due to your muscle repair or lack of muscle tone. I would try the use of a Pilates style regimen to strengthen your core muscles prior to revising your tummy tuck.

Nina S. Naidu, MD, FACS · Answer

I'm a little unclear as to how far you're out from your initial surgery. You may have swelling, if this is very early, or your muscles may not have been tightened enough. If you are a year out from surgery, you could certainly explore revision, as a tummy tuck should leave you with a flat abdomen in the absence of weight gain. You may want to speak with your initial surgeon about this, or if you are not comfortable, with a new surgeon. Good luck, /nsn.

Scott E. Kasden, MD, FACS · Answer

It sounds like the muscle layer is indeed lax after the repair.  To be sure, you may want to seek a second opinion, as it is not possible to make a diagnosis based on verbal description alone.
I would say that 9 months to a year after the initial surgery should allow adequate healing to consider a re-do.

Peter A. Aldea, MD · Answer

From your comments I am guessing that you HAD a Tummy tuck and that you still have a residual pooch when you push out. That you operating surgeon suggest you camouflage with Spanx and that another plastic surgeon feels that the reason for the pooch was insufficient muscle tightening not fat ("little fat under skin that not an issue").
Since the second Plastic surgeon is the only one who examined you and he feels he could get you a better result, I cannot doubt him. I would advise you wait 6-8 months for the tissue to mature and achieve full healing and maintain stable wait. Revision tummy tuck is not as easy as the first time the operation is done because the plane of the surgery is scarred. Although an improvement is possible, I would make absolutely sure that the improvement is worth the risk.

George J. Beraka, MD (retired) · Answer

Hi.
1)  Wait six months before you have a revision tummy tuck.
2)  If you are like most people, there is no reason why you should not have a flat stomach after a tummy tuck.
3)  Get another opinion.  What went wrong the first time?

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