Weak abdomen muscles

Body contour deformities are both a self esteem weakening factor and a source of personal hygiene issues, chronically sore creases, body odour, sexual inhibitions, social concerns and even somehow a functional limitation in daily activities, work, sport, etc.

Saggy abdomen or flaccid tummy deformity is a typical sequel of either pregnancy after effect or massive weight loss achieved either by diet control plus exercise or by means of bariatric surgery, with greater or lesser role of the aging suitable to the stage of life, which lead to a variable grade of cutaneous excess at the anterior abdominal wall, forming a hanging skin effect mainly at the lower abdomen or suprapubical.

This cutaneous droopy apron may be limited to the suprapubical area, in whose case only a panniculectomy or mini tummy tuck would be necessary to get rid of it; commonly the spare panniculus extends from upper to lower abdomen with predominance of vertical excess of skin, being then indicated a traditional abdominoplasty or tummy tuck with an horizontal scar, with or without muscular reinforcement and diastasis recti repair; however massive weight loss cases show, besides the vertical panniculus, a significant horizontal excess of skin, making them candidates to the so called fleur de lis, inverted T or anchor abdominoplasty or tummy tuck.

Underlying to the cutaneous problem and almost exclusively in post pregnancy cases the muscular girdle of the abdomen may suffer diastasis recti or widening of the midline tendon known as linea alba which joins the two rectus muscles and the two halves of the abdomen in the midline, a problem known as weak core; this is best treated with the linea alba suturing plication to reinforce and tighten the abdominal wall so that a flat profile is restored; less commonly the oblique muscles might also be affected and require plication.