We often talk about performing a tummy tuck with muscle repair and I would like to clarify what we mean by that.
The muscle in question is the rectus abdominis muscle which is the six pack.
Although the six-pack looks like horizontal lines across your abdomen, it is actually a vertically orientated muscle that goes from your rib cage straight down to your pubic bone.
There are two rectus abdominis muscles which sit side-by-side.
At intervals along the length of the muscle there are ridges called tendinous intersections. It is these that create the appearance of the six-pack.
These muscles can be spread apart when the intra abdominal contents increase and swell up.
This commonly occurs during pregnancy and when putting on weight.
When the swelling goes down, sometimes the muscles don’t come back together again leaving a gap between them.
This is known as divarification of the rectus muscles.
It is not that the muscles actually need to be repaired but more that they need to be brought back together.
If you are wondering whether you need to have your muscles repaired or not then you can demonstrate divarification of the rectus muscles by lying flat on your back and performing a straight leg raise.
This will tense the rectus muscles and if they are not sitting next to each other, you will be able to see a bulge or feel a gap between them above your belly button.
It is routine to repair the rectus abdominis muscle when performing a full tummy tuck or a fleur-de-lis tummy tuck.
This is because the operation involves releasing the skin and fat all the way up to the rib cage, so the whole length of the rectus abdominis muscle is exposed.
This is not the case with a mini tummy tuck because the belly button is left in place and we can only access the lower abdomen below the belly button.
This means that we cannot repair divarification of the rectus muscles when performing a mini tummy tuck.
Patients sometimes ask specifically to have the muscles repaired when requesting a tummy tuck but this is something that we will assess and repair routinely for anyone having a full tummy tuck or a fleur-de-lis tummy tuck.
If you are having your rectus abdominis muscles repaired, it can be a little bit uncomfortable and so do not be surprised if you wake up after surgery with discomfort centrally above your belly button and it can be uncomfortable to cough because this will put tension on the muscle repair.
Sometimes people think that they have a hernia but divarification of the muscle is not strictly a hernia in itself.
A hernia is a defect in the abdominal wall whereas divarification is a weakness in the abdominal wall.
Most plastic surgeons will be comfortable repairing hernias or divarification of the rectus muscles and so whatever the cause of the weakness or bulge in your abdominal wall, we should be able to fix it for you.
If you have any questions about tummy tuck with muscle repair or tummy tucks in general, you can comment below or email me at firstname.lastname@example.org.
I perform a live Q&A every Tuesday at 7pm on Facebook and so you can catch me there if you want to ask a question.
You can download my tummy tuck guide here.