Tummy tucks are not just cosmetic
Abdominoplasty surgery is not just to make the belly look better. There are real functional improvements, statistically significant, to improve urinary incontinence and back pain. The back makes sense to me- the abdomen and the back make up your core. If the abdomen is weak, the back has to compensate. But improving it so you don’t pee when you laugh or cough? Why would that be?
We know it is real. There are studies which prove it.
What are the theories on why it improves urinary incontinence?
There are many theories.
- The continuity of the anterior abdominal wall is reconstructed. This restores a functional synergy with the pelvic floor. STUDY: Could Abdominoplasty with Diastasis Recti Abdominis Correction Improve Stress Urinary Symptoms? A 1-Year Follow-up Prospective Study
- It tightens the abdominal muscles, which were stretched, to restore physiological intra abdominal pressure. When the muscles are loose, there is a change in the positive pressure generated by the abdominal muscles, which may lead to incomplete emptying of the bladder.
- Tightening the skin helps reduce the hypermobility of the urethra. This is because you are restoring Scarpas to Colles fascia internally, which contain the urogenital diaphragm and external urethral sphincter. STUDY: Female pelvic floor anatomy: the pelvic floor, supporting structures, and pelvic organs
- The abdominal muscles and the pelvic floor muscles are part of the “abdominal canister” and generate intrabdominal pressure, so when the abdominal muscles are weak, they are closely related to the pelvic floor, and the pelvic floor muscles lose strength and endurance
What are theories on why it helps back pain?
- The rectus muscles are put back in the correct position. This may ensure basic muscle tone necessary to maintain correct posture.
- The rectus muscle needs to be stronger to oppose the contraction of the spinal muscles, to prevent hyperextension of the back. When these abdominal muscles are reduced, there is an overload to the posterior muscles of the back, resulting in pain. STUDY: Diastasis of rectus abdominis muscles in low back pain patients
- Weak fascia after pregnancy, weight changes, and menopause lead to increased type III collagen, which gives greater flexibility. This may lead to hyperextension. STUDY: Collagen content of nonsupport tissue in pelvic organ prolapse and stress urinary incontinence
- Weaker transverse abdominus muscle may lead to lumbar pelvic instability. Improving the abdominal wall muscle integrity helps this.
My thoughts
I love the theories. When I started my practice, I didn’t appreciate the true reconstructive nature of a tummy tuck. As I have entered my healthspan and longevity focus (yes, the benefits of your plastic surgeon also being a mom of three and in menopause), I really think about your whole body health. Tummy tucks reconstruct your core. This helps with fundamental health issues.
- If you have back pain, are you exercising? able to do the things you want to do? Back pain will affect your lifestyle, weight, and activities of daily life. Back pain is debilitating.
- If you have urinary incontinence issues, do you stop running? do you need to wear a pantiliner every day? If you wake up every night to pee, are you getting good sleep? Sleep is key for avoiding dementia, weight gain, and other medical issues. I had one patients who had to go pee every night 4-5 times. After her tummy tuck? Slept through the night. That will have REAL medical benefits for her.
- Improving core strength can help you build muscle and be more active. Not only is that more fun (pickleball? skiing?), muscle mass helps prevent dementia, improves bone health, and lowers insulin resistance.
So I am a huge fan. Not only does it make you look better, it has real health benefits.
Medical citations
Female pelvic floor anatomy: the pelvic floor, supporting structures, and pelvic organs
Diastasis of rectus abdominis muscles in low back pain patients
Collagen content of nonsupport tissue in pelvic organ prolapse and stress urinary incontinence
The information provided on this website is for general informational purposes only and does not constitute medical advice, diagnosis, or treatment. Always seek the advice of a qualified healthcare provider for any questions regarding your health or medical condition.
