Is it Possible to Have Tummy Tuck Without Muscle Repair?

Question

After having two babies over 20 years ago, my stomach was normal, no muscle damage, etc. About ten years ago I gained over 60 pounds. I lost this weight two years ago and have been able to keep it off. I am looking into a tummy tuck because of excess skin on my stomach. My question is, because the muscles didn't get damaged, can I do a tummy tuck that would not include muscle work? That would instead be removing excess skin and body contouring only?

John J. Corey, MD · Answer

Sure you can!! I do see patients that already have a very tight, muscular abdomen, that just need the skin tightened up (just did one this week!). It is less common and you need to make sure that you really will be satisfied with the muscle wall tightness if nothing is done!! And the recovery is much faster...

Gary M. Horndeski, MD · Answer

Dear Kathy,

	I feel I need to clarify a few things for you. Pregnancies and weight gain result in large increases in intra-abdominal volume. The abdominal wall will stretch and change accordingly. Muscles elongate without tearing. However, the fascia (which surrounds the muscle) may stretch and tear. When the fascia tears completely it is called a hernia. Partial tears result in diastasis (weakening). With your history of two pregnancies and a sixty pound weight change, it is most likely that your fascia has been damaged. Repairs done during TT are not to the muscle but to the fascia. In your case, I would recommend you undergo fascia repair. This adds very little time to the procedure and increases the mechanical strength of your abdominal wall. There are recent articles published on the use of mesh to reinforce the abdominal wall with TT. A strengthened abdominal wall is flatter, more attractive and maintains reduced weight. Best wishes,

	Dr. Horndeski

Jonathan Saunders, MD · Answer

you can absolutely have a tommy tuck without muscle reconstruction, but there is a trade off. you will have a less painful quicker recovery, howeveryour abdomen will not be as firm or flat afterwards. if you truly have lost 60 lbs after having kept it on for 18 years i suggest the plication. it is like you had a 60 pound pregnancy for 18 years

J. Jason Wendel, MD, FACS · Answer

Yes, it is definitely possible to do a tummy tuck without the plication, muscle repair, portion of the procedure. You may want to discuss with your surgeon the possibility of doing muscle repair if he/she indeed encounters diastasis recti during your procedure, and leave it up to him/her as a decision durign surgery. However, if you don't want it, them tell your surgeon not to do it. Your body, your call. I hope this helps.

William B. Rosenblatt, MD · Answer

Leave it up to your plastic surgeon to decide. I have found that as long as you had children, you can use a tightening of the muscles. It improves the result.

Robert L. Kraft, MD, FACS · Answer

It is possible to perform a panniculectomy to remove just the skin or a tummy tuck without tightening the muscles.  Only a consultation with a board certified plastic surgeon will enable you to know whether options short of the full tummy tuck would be available to you.

Tom J. Pousti, MD · Answer

Thank you for the question.

	Yes, it is possible to have the tummy tuck procedure done without  muscle plication.  Whether you are a good candidate for this option will depend on your physical examination.

	Generally speaking,  it  is unusual to see a patient who has had 2 pregnancies and who has had 60 pound weight gain/loss  who does not have  separation of the rectus muscles of the abdomen. 

	Again, it will be in your best interests to be examined in person by well experienced board-certified plastic surgeons before making a determination  to &ldquo;skip&rdquo; the muscle plication  part of the tummy tuck procedure.  Keep in mind that for the average patient the plication does significantly improve  the end results of surgery.

	Best wishes.

Brooke R. Seckel, MD, FACS (retired) · Answer

Thank you for your question.  If there is no separation or split in her abdominal muscles after your pregnancy then a tummy tuck that only removes excess skin and tighten the tummy can be done without muscle repair.   Muscle repair is only done when the 2 large abdominal muscles are split.

Ronald V. DeMars, MD (Retired) · Answer

Of course it is possible to omit muscle repair and just resect excess skin and the fat attached to the skin. If your abdomen is relatively flat now when standing and NOT holding your muscles tight that may be the right choice for you. But see a aurgeon for an exam and if the muscles are separated (he can easily tell when examining you) and there is some roundness to your abdomen, you will get a more satisfying result. In our practice we do not charge more when doing the muscle repair. It does make for a mor painful surgery but with the pain pumps that we have used for several years, the discomfort is very well controlled.

Mary Lee Peters, MD (retired) · Answer

Congratulations on your successful weight loss. Most people wirth a large weight gain and loss have a lot of folds of extra skin. Most also have some separation of the lining between the rectus muscles (sometimes called the sit up muscles). This space is called a diastasis rectus. It is possible to perform a tummy tuck and not repair the muscles. This choice is infrequently made because you may be compromising the improvements that are possible when the muscles are returned to their normal anatomical position. Stay open to all the suggestions your plastic surgeon makes in your behalf so as to get the most from your procedure. Good luck!

Is it Possible to Have Tummy Tuck Without Muscle Repair?

Answers (11)

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