The purpose of this page is to discuss in some introductory detail about the muscle tightening option portion of a Tummy Tuck procedure.  For most plastic surgery patients, this is considered a crucial part of a Tummy Tuck, according to Dr. Tammy Wu, Modesto Plastic Surgeon.

Before discussing muscle tightening, let’s discuss some anatomical features of the anterior part of the abdomen.

Rectus Abdominus Muscle

• This is the muscle that runs up and down the front of the abdomen
• When very toned, it gives a person a “6-pack” or some other variable number.
• It is separated by a thin fascia (sometimes known as the linea alba) that connects the left and right sides of this muscle.

Rectus Diastasis

• Sometimes this thin fascia in the middle of the Rectus Abdominus Muscle (Linea Alba) can start to separate due to pregnancy or being over weight.
• This is not a hernia
• It is sometimes thought to be a hernia.  Detailed surgical examination, physical exam, patient surgical history and radiological studies can sometimes help us determine if it’s a hernia or rectus diastasis.   We consider a hernia a medical problem, but a rectus diastasis to be cosmetic issue.

Muscle Tightening of the Rectus Abdominus Muscle

• This is commonly done with a Tummy Tuck.
• Involves bringing the muscle closer together on the midline – called plication.
• Various methods are used with sutures.
• We prefer interrupted, separate sutures which are of a permanent material, but soft.
• The plication occurs for the entire length (vertically – up and down) of the abdomen in the middle.
• No separate skin incision is needed for this.  Through the lower incision used in the Tummy Tuck (left and right / horizontal) incision, we dissect through that incision to be able to reach all the way up to nearly the xiphoid process, which is the bottom of the chest bone (sternum).
• There is no entry into the abdominal cavity (peritoneum) with these sutures.  It’s just in the muscle layer only.

Muscle Tightening narrows the abdominal girth in the middle of the abdomen

• It gives more of that hour glass shape
• Muscle tightening is not part of a panniculectomy procedure (which is a “tummy tuck  – like” procedure that simply removes the skin and fat tissue).
• But muscle tightening is certainly an option considered in Tummy Tuck procedure.

Post Operative Discomfort

• It does add to some more post operative discomfort, but we like to recommend that patients have us use a disposable pain pump to conteract the possible added discomfort with muscle tightening
• The pain pump is available, usually for a separate cost, paid directly to our Modesto Area Hospitals which we currently operate in.
• Most of our Tummy Tucks in Modesto, CA are with the muscle tightening procedure option.