Tummy Tuck with Oblique Fascial Plication

Q: Dr. Eppley, I had a question regarding a tummy tuck. I read of doctors over seas do it as regular with abdominal repair and their patients look a little more hour glass shaped. But I have not read many in America do it and the ones that said they do if requested don’t have before and after pictures of “oblique repair” I know that sutures are placed in the abdominal muscles usually in a tummy tuck and that does make the waist smaller and stomach slimmer. But can sutures be placed in the obliques as well and pulled in to give that really curve pinched drastic look like a corset does or close to it… basically changing the waist shape?

A: What you are referring to is the overall concept of fascial plication and not muscle repair. It is standard to almost always do midline rectus muscle fascial plication in a tummy tuck whose intent is to push back or flatten abdominal projection. This has no effect on horizontal waistline reduction. Fascial plication can also be done on the oblique abdominal muscles as well if the patient so desires. This can have some effect on waistline narrowing in the horizontal direction. The significance of its effect depends on the muscle/fascial laxity of the outer abdominal wall.  There is nothing novel or unique about oblique fascial plication, it is just the additional use of sutures for maximum efforts at waistline shaping. But do not be under the misconception that it can have a corset-like effect as it can’t. Its effect will not be that substantial.

Dr. Barry Eppley
Indianapolis, Indiana