Tummy Tuck Redux?

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Abdominoplasty, or tummy tuck surgery, is a procedure that most often delivers great satisfaction. It targets both loose muscles and skin, tightening up an area that was formerly flabby due to massive weight loss, pregnancy or simple genetics. Tummy tuck patients typically try to improve their bellies with diet and exercise before coming to the realization that slack skin and muscles just can’t be fixed without the help of a surgeon.

In the hands of a skilled, experienced plastic surgeon, abdominal muscles can be stitched up tight, stubborn fat pockets banished with a little liposuction and excess skin removed. Patients are generally happy, even joyful, to have a smoother, flatter stomach. But, for a rare few, the tummy tuck does not yield that hoped-for result. Why? If this is the case for you, should you opt for a do-over?

One very important step in evaluating why your tummy tuck did not work out as you planned is considering how long it has been since surgery. If just several weeks have passed, be patient. Although you may be feeling more or less back to your old self, it can take as long as six months for all your swelling to subside.

If several months have passed, it could be that you did not achieve your desired result due to surgical technique, your particular body, post-operative complications or some combination.

At the heart of abdominoplasty in most cases is tightening of the muscle fascia, or the tough lining of the muscles running vertically down the abdominal wall. Occasionally a surgeon will not tighten the fascia—if a patient is planning a future pregnancy, for instance, and just doesn’t want to wait to have surgery until afterward (a young weight loss patient, perhaps). But in the vast majority of surgeries the fascia is stitched together. You can visit your doctor and ask him or her to review their surgical notes with you to understand just what was done.

It won’t surprise you to know that every person’s abdomen is different, and some people have very loose muscle fascia. The medical term is diastasis recti. Ask your plastic surgeon about this. It’s likely you’ll find the doctor tightened up your tissues as much as he or she felt was safe for you.

If you resume strenuous exercise too soon or experience a sudden muscle strain, it’s possible to rupture internal stitches and impact the healing process. Since most plastic surgeons use a number of smaller sutures instead of fewer long stitches, even if you pop one or two you should still be ok. But if you have any concerns about your healing, see your doctor.

If years have passed and the tummy pooch is returning, take a good hard look at your lifestyle and ask yourself how you may have contributed. Do you get enough exercise to maintain the strength of your core muscles? As you know, any muscle, whether or not surgically treated, will lose tone over the years if not it’s not put to work. Have you maintained your weight at or near your ideal level? Body fat can creep onto your frame, and fat inside the abdominal wall can especially give you that pre-tummy tuck look.

The good news is that most surgeons say it’s likely your abdomen can be further improved the second time around. Visit your original doctor or choose another board certified plastic surgeon with great experience, listen carefully to the surgical plan and pledge to do your part to heal and maintain your new shape.

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We value and respect our HERWriters' experiences, but everyone is different. Many of our writers are speaking from personal experience, and what's worked for them may not work for you. Their articles are not a substitute for medical advice, although we hope you can gain knowledge from their insight.