Are the stomach muscles always repaired during a complete abdominoplasty? What would be the point in not repairing the muscle?

Most patients who undergo a tummy tuck surgery want to achieve an abdominal contour as flat as possible. In the majority of patients who present for abdominoplasty surgery, the abdominal muscles bulge to various degrees from weight fluctuation, previous surgery, or pregnancy. Tightening the muscles will lessen bulging of the abdominal wall. There are some instances where a person has flat muscles that are tone and do not cause muscle bulging. If the muscles are flat and tone, often seen in women who have not had children or in men, tightening of the muscles may have no affect on the outer contour and result. Another group of patients who may not need or want muscle tightening are young women who have loose skin from weight loss, yet want to have kids so that tightening the muscles at an early stage may be an unnecessary nor worthwhile part of the procedure. When you do not tighten the muscles, the operating room time is reduced and patients tend to recover faster with less discomfort and time off work.

The muscles are usually always repaired to achieve a flat look of the abdomen. You may not repair in a patient who still wanted the option of having kids in the future, a patient who has a large hanging section of skin and this is the only concern. Sometime, the core is very tight already. Good luck

It is not always necessary to repair the abdominal muscles. There are circumstances in which there is no or minimal stretching of the abdominal wall. I have myself performed a few abdominoplasties on men who had lost significant weight and had excess skin of the abdomen but negligible stretching of the abdominal wall. I've also had a few women, who even after a pregnancy, had minimal laxity of the stomach wall and who neither wanted nor really needed any muscle tightening. Each surgery must be customized for the individual, depending upon their circumstances, physical condition at the time of surgery and their desires for the surgical result.

In most of cases of abdominoplasty, I repair muscles in the wall of the abdomen. The result of such a suture gives a better cosmetic result and a flat tummy. In young patients who want to have more children or are not sure to go for another pregnancy, I don't place sutures on muscles. In the future when they are done with the "family plan" I proceed with muscle repair.