Muscle repair is needed when the abdominal muscles are separated. It is called Rectus Diastasis. It can happen from pregnancy, obesity, and in some cases it is from birth.
For example, I have Rectus Diastasis and I was never pregnant, nor was I ever obese. (Ricardo L. Rodriguez, MD, Baltimore Plastic Surgeon)
Rectus muscle plication depends on each case
The key will be based on your examination by your board certified PS. If you have a diastasis then you would likely benefit from a plication.
If there is no diastasis but your muscle wall seems loose you may still have an improvement in your result with plication sutures. (Gaurav Bharti, MD, Johnson City Plastic Surgeon)
Tummy tuck and muscle repair
A muscle repair is not always required as part of a tummy tuck, they are just commonly associated, as the muscles and skin have usually both been stretched by the same thing.
As part of your consultation with a plastic surgeon, they will examine your muscles and check if they are separated or if there is some laxity in the muscle wall.
If that is the case, then tightening the muscles will improve your overall abdominal shape. (Richard Bloom, MBBS, FRACS, Melbourne Plastic Surgeon)
Muscle repair during a tummy tuck
The abdominal muscles may be stretched/lax from weight changes, in addition to someone having a prior pregnancy. An examination in person with a board-certified plastic surgeon can help determine if this is recommended – or not – for your particular situation. if you have not had children and are planning to do so in the future – I recommend holding off on a tummy-tuck until you are done having children. (Joseph D. Alkon, MD, Newark Plastic Surgeon)
Muscle Repair in a Tummy Tuck
Often from children the abdominal muscle are separated and stretched (diastasis), and require repair as part of a tummy tuck procedure. However, sometimes women and men have this muscle separation from birth, prior tummy surgery, or just from weight fluctuation. Even when the muscles are not separated, some surgeons will perform tightening of the muscle as part of tummy tuck surgery to improve the result.
That is my practice – I repair or tighten the abdominal muscles for all patients. (Cory Goldberg, MD, Toronto Plastic Surgeon)
Tightening the abdominal wall can be beneficial even if you have not had children. I typically do not do that for women who are planning on having children down the road. In those cases, I remove skin and fatty tissue only. (Michael Hueneke, MD, Nashville Plastic Surgeon)
There are two things accomplished with muscle repair. One is to lessen the space that childbirth and other stresses can cause. The second is that sutures in the layer of tissue overlying the muscle, called fascia, can be placed to help define a better shape. Think of it as an internal corset. A dramatic change is not usually sought or achieved with these sutures but the effect can be significant enough, when coupled with a tummy tuck, to make them worthwhile for shaping not just for repair. (Jeremy Pyle, MD, Raleigh-Durham Plastic Surgeon)