Q: Dr. Eppley, I am interested in getting a tummy tuck but have a few questions about it. In reviewing the photos of other women whom have had the procedure, I noticed that the scars are up fairly high, is that necessary to achieve proper results? You see, in having two cesarean births, both incisions were very neat along the hairline, I really like the way it had healed. Do you cut through the muscle in this procedure? Oh, and the other thing, in viewing some post-op footage, there were these drainage apparatus, is that something always done? Sorry for all of the questions, I hope you don’t mind.
A: A full tummy tuck always pulls the incision up higher than a mini- or more limited tummy tuck. Only a min-tummy tuck can keep the incision as low as most women have their c-sections scars at. C-section scars should almost always heal beautifully because they are closed under no tension. (loose stretched out skin) Tummy tuck scars rarely look quite that good because they are close under considerable tension. (tight taut skin) Tension is the enemy of a narrow scar line.
No muscle is ever cut though in a tummy tuck of any form.
The use of a drainage tube is a necessary evil after tummy tuck surgery that stays in for about a week.
Dr. Barry Eppley
Q: I just have a question about tummy tucks. I have wondered whether it is important to have the stomach muscles tightened. I met a surgeon and he said it is not necessary for me, as I am young (23) and have not had any children. He did assess me. In your opinion (without examining me), could you agree with his statement?
A: Tummy tuck surgery has the capability to address all three components of the abdominal wall, skin, fat and muscle. While it may be fairly routinue to perform muscle tightening as part of tummy tuck surgery, it is not always necessary. The important question is whether muscle laxity or midline rectus separation is making any significant contribution to the protruding shape of the stomach area…or whether an umbilical or ventral hernia is present. If a woman has never been pregnant and does not a hernia then it is unlikely that muscle plication will be of any benefit. Interestingly, tummy tucks done in men do not usually involve muscle tightening as those muscles have never been stretched out due to pregnancy. Muscle manipulation is what causes the greatest amount of pain in a tummy tuck and should only be done if there is a compelling reason to do so. Skin and fat removal is always done and is the backbone of tummy tuck surgery. At 23 years of age and having never been pregnant, I would agree with your plastic surgeon that it is not necessary for your tummy tuck to include muscle manipulation.
Dr. Barry Eppley