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Plastic Surgery/Failed muscle repair after TT


I had a tummy tuck in Oct. 2012. Had a sudden bludge in upper abdomen that may now be larger) I have lost 15lbs after surgery.   In Feb 2013 Dr. Ordered CT scan that shows a 2cm tear in facial tissue above belly button.  Originally I was flat.  When I lay down my stomach sinks in and ribs pertrude out. Originally surgeon discussed mesh or sliding muscles apart and reattaching. I originally did not want to do mesh because o f possible infection, but now see alternatives to synthetic mesh.  I went from looking 7 mo. Pregnant to 5 mo. And totally flat below bely button.  Surgeon  now says 2cm separation not worth surgery, but due to weight loss and, that tear maybe larger, wants another scan.  My abdomen was 37 inches, then 34in, after tear 36.5 in.  What are repair options. I think it is. Worthy of revision, do you agree?  Thank you!

Hi Laura,

It's obviously not possible to offer a complete and accurate assessment via this forum, without an exam, without knowing what you looked like before, etc., but I'll try to share some thoughts.

The area above the umbilicus (belly button, or BB) is, in my opinion, often not "corrected" to the degree that patients want and hope it will be.  That region tends to protrude as a result of fat (and tissue) that is behind the abdominal wall, rather than in front of it and, partly because of that, is much less amenable to improvement than the lower regions, where there is both more fat above the muscle (superficial to it) and excess skin that can be removed.  The combination of all of this means that there are many patients who have a more dramatic improvement for the region below the BB than above.

I don't know whether this applies to you but it does not seem like a 2 cm separation warrants an additional surgical procedure.  Mesh is a good option but neither it nor anything else is risk-free.  How would the surgeon get to the area that needs the mesh?

When you put all of this together, I would probably agree that it's okay to do another scan but I'm not sure an additional procedure is warranted, even with the understanding that you may not have achieved as much correction as you'd hoped.

I hope that this helps and good luck,
Dr. E

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Alan M. Engler, MD, FACS


Dr. Engler has answered over 6400 questions on social media sites, including over 3500 on AllExperts alone. His expertise includes breast surgery (breast enlargement with implants, breast reduction, breast lifts), liposuction, eyelid surgery, tummy tucks, facelifts, lipomas, skin cancers, cysts, etc. Dr. Engler has been listed as one New York`s Top Doctors, and as "One of the World's Most Famous Aesthetic Surgeons" (Aesthetic Surgery, TASCHEN Books, Angelika Taschen, Editor). He is the author of 4 books, including "BodySculpture" (a best-selling plastic surgery book on breast surgery, liposuction and tummy tucks), "EyeScapes" (Plastic Surgery of the Eyelids), "Restylane," and "The Slim Book of Liposuction." Dr. Engler has two US Patents for surgical instruments that he's designed, and has appeared on numerous television shows, including The Tyra Banks Show, The Ricki Lake Show (four times), the Dr. Keith Ablow Show and Jerseylicious. Videos of his appearances are available on YouTube (search for "DR. ENGLER"), and his discussion of breast implants, also on YouTube is "How to Choose a Breast Implant." His website is Follow Dr. Engler: @AlanEnglerMD


Dr. Alan Engler is a board-certified plastic surgeon in New York and the author of BodySculpture - Plastic Surgery of the Body for Men and Women (ISBN 0966382749) one of the top-selling plastic surgery books on,, as well as EyeScapes - Plastic Surgery of the Eyelids.

Dr. Engler graduated from Yale University (BA, Russian Studies) and the Columbia University College of Physicians and Surgeons (MD). He did his residency training in General Surgery and, after that, Plastic Surgery, at the Montefiore Medical Center in New York. He is on the faculty of the Albert Einstein College of Medicine in New York in the Departments of both Surgery (Plastic Surgery) and Medicine (Dermatology), and is a Special Lecturer in the Department of Dermatology at Columbia University in New York. He has admitting privileges at Beth Israel Medical Center and Montefiore Medical Center, both in New York.

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