Tummy Tuck: Prices, Photos, Reviews, Info, Q&A

To Tighten or Not To Tighten Your Abdominal Muscles?

With pregnancy, the abdominal muscles have to separate some in all women and that is normal.

How much they separate is highly variable as is also how close they come back together after delivery.

Also, with time, in many women, the abdominal muscles will continue to spread as age and gravity push the abdominal contents up against the wall leading to the middle-age pooch in the lower abdomen.

These are reasons that many plastic surgeons will recommend tightening the abdominal muscles during an abdominoplasty.

Abdominoplasty muscle tightening picture

However, as many of the other plastic surgeons who have responded to your question have noted, in some women, the amount of separation of the muscles is minimal and their core strength very tight, so for these women, they may not require tightening of the muscles.

Really, only the plastic surgeon who performs your exam can help you make that decision. If you are concerned with their answer, obtain a second opinion with a board-certified plastic surgeon. This is too big of a decision to proceed with until you are completely comfortable with your options. (Herluf G. Lund, Jr, MD, Saint Louis Plastic Surgeon)

Muscle tightening with abdominoplasty

Abdominoplasty muscle tightening image

An examination of your abdomen is necessary for a fully accurate answer, but a woman with 2 pregnancies and the photos you showed, I would typically feel that a muscle tightening procedure would be included.

If you inhale and your abdomen tightens significantly, and if you have a separation of the muscles in the midline than that would confirm it. I would return and discuss things with your surgeon. (Rick Rosen, MD, Norwalk Plastic Surgeon)

Does a tummy tuck always involve muscle tightening?

An abdominoplasty muscle tightening

An abdominoplasty following childirth almost always necessitates muscle tightening. It is unusual not to perform one because the muscles are usually stretched and separated after pregnancy(ies). The photo does not allow to speculate whether the muscles ae firm. I would discuss again with your surgeon why he (she) feels that muscle tightening is not necessary. You may want to seek a second opinion regarding the need for muscle tightening. (George Lefkovits, MD, New York Plastic Surgeon)

Muscle tightening is usually done with abdominoplasty

It is extremely rare for a woman not to require muscle tightening (plication) after having delivered children. I would say this is done in nearly 100% of tummy tucks-it’s what creates a flat profile. I would discuss this in detail with your plastic surgeon before having surgery. (William Bruno, MD, Beverly Hills Plastic Surgeon)

Is it logical NOT to do a Muscle Tightening in a Tummy Tuck?

The abdominoplasty muscle tightening

Mother’s are quite familiar with the damages associated with one or multiple pregnancies. Consider the process for a minute. The normal non-pregnant uterus is the average size of a lime. With pregnancy it grows into the size of a large watermelon with PERMANENTLY stretches everything in its path:

– in stretches the abdominal wall muscles AND splits the six pack (Rectus Abdominis) muscles thereby creating “The Pooch’ or a larger volume abdominal cavity

– it stretches and cracks the skin (ie “stretch marks”)

– it stretches the pelvic diaphragm creating various degrees of uterine prolapse and urinary stress incontinence in some women.

If YOUR house wall had cracking paint AND cracking sheet rock do you think dealing with the paint would be a wise long term restoration and solution?

Abdominoplasty muscle tightening photo

Why would anyone be willing to walk away from the muscle repair portion of a abdominoplasty in a woman with abdominal wall laxity? It does not really matter how strong these muscles are when contracting. It is much MORE important where they are located when they are at rest which is where we spend most of our lives. Pregnancy has both stretched them and separated them in the middle.

A well done tummy tuck muscle repair would tighten the abdominal musculature in the midline resulting in a FLAT abdomen and a narrowed youthful waist upon which a greater amount of stretched out skin can be removed. That would give you the best result. I think you need a second opinion. (Peter A. Aldea, MD, Memphis Plastic Surgeon)

Muscle Plication and abdominoplasty

Abdominoplasty muscle tightening image before surgery

I think you are very smart to wonder about the omission of abdominal wall plication during your abdominoplasty procedure. Hopefully you’re working with a well experienced board-certified plastic surgeon who has made a good decision to not plicate the abdominal wall muscles during your tummy tuck procedure. He/she will be in the best position to determine whether or not you will benefit from the muscle plication. Having said that, at least in my experience, it would be very unusual for a в parent of 2 not to have some degree of abdominal wall laxity that will benefit from plication. This tightening of the abdominal wall will improve the end results of the tummy tuck. I suggest confirming the training/credentials of your plastic surgeon and expressing your concerns with him/her again. If still in doubt, obtain a 2nd opinion. (Tom J. Pousti, MD, FACS, San Diego Plastic Surgeon)

Muscle tightening in abdominoplasty

Abdominoplasty muscle tightening before photo

The vast majority of women will benefit from muscle tightening, especially if they have finished with their pregnancies. I have seen the occasional woman who has a very firm core, in which case there really is not any more to gain. I can’t tell from the photos how “loose” your tummy muscles are. you would need to really relax your tummy and see how much it buges forward. The advantage of not doing the muscle tightening is that the recovery is quicker and there is less pain. (Ronald Schuster, MD, Baltimore Plastic Surgeon)

Muscle tightening in tummy tucks

Each patient needs to be evaluated and examined to determine what the best procedure would be. Most women need some tightening of the abdominal wall during a tummy tuck especially after having children and c sectioning. Discuss this with your surgeon again to clear up any confusion prior to surgery. You don’t want any regrets after. (Albert Dabbah, MD, Boca Raton Plastic Surgeon)