Your rectus abdominal muscles or your ‘abs’ is the vertical support for the front of your abdomen. The rectus abdominal muscles are often referred to as one of the important muscles that constitute your abdominal ‘core’.
About 50% of pregnant women struggle with separated rectus abdominal muscles that no amount of sit-ups, abdominal planks or crunches will repair.
The impact reaches far beyond appearance – back pain, poor posture, and reduced core function affect daily activities from lifting groceries to playing with children.
Muscle plication surgically restores what exercise may not be able to, bringing separated abdominal muscles back to their original and optimal position with precision and permanence.
While traditional core exercises strengthen the existing abdominal muscles, only abdominal rectus muscle plication repairs the abdominal muscle separation and puts the abdominal rectus muscles back in the midline where they belong.
Let’s explore how muscle plication surgery may be able to help you in your journey to restore your pre-baby body.
Understanding Muscle Plication
What is Muscle Plication?
The separation of your rectus abdominal muscles may occur from a single pregnancy or after multiple pregnancies. Significant weight gain and obesity can also cause separation of your rectus abdominis muscle.
When these muscles separate or weaken, the strength of your abdominal wall becomes compromised. Abdominal rectus muscle plication brings the muscles back together in the middle of your abdomen, vertically from underneath your rib cage to your pubic bone, using precise surgical techniques.
This surgical repair is performed in approximately 95% of tummy tuck procedures, though some patients may not be candidates for muscle plication due to their specific circumstances.
This procedure creates what we call an “internal corset,” providing lasting support to the abdominal wall while improving external appearance.
The rectus abdominis muscles, which run vertically along your abdomen, can separate due to various factors as:
- Pregnancy, where hormonal changes and uterine expansion force the muscles apart (particularly during multiple pregnancies or with twins)
- Significant weight fluctuations that repeatedly stretch and contract the abdominal wall, weakening its natural tension
- Improper form during heavy lifting or intense core exercises, creating excessive internal pressure that forces muscle separation.
Through muscle plication, the abdominal muscles are carefully brought back to their optimal position and secured with strong, permanent sutures.
As a specialized form of stomach muscle surgery, this procedure addresses both cosmetic and functional concerns.
Note: Muscle plication differs from a traditional tummy tuck because it often does not address removal of skin and fat, which is performed in a tummy tuck surgery.
Related: Abdominal Liposuction vs Tummy Tuck: What’s the Difference?
Who Needs Muscle Plication?
Post-Pregnancy Diastasis Recti
Pregnancy muscle separation affects countless women, often leading to persistent core weakness. Surgical diastasis recti repair becomes necessary when the separation exceeds normal physiological limits.
Many women find themselves unable to restore their pre-pregnancy core strength, despite dedicated exercise routines.
Common symptoms include lower back pain, poor posture, and the appearance of a persistent “pooch”.
Restore your pre-pregnancy core with Dr. Lo’s Mommy Makeover and experience lasting relief and regained confidence.
Weight Loss Related Muscle Laxity
Individuals who have achieved significant weight loss often discover that their abdominal muscles have stretched beyond their natural ability to retract.
This creates not only aesthetic concerns but functional limitations as well. Activities requiring abdominal core strength become challenging, and the loose separated abdominal muscle can contribute to poor posture and back strain.
Genetic Muscle Weakness
Some individuals inherit a predisposition to a weaker abdominal muscle wall. This genetic factor can manifest as early as young adulthood, leading to reduced core strength and stability.
Early intervention through muscle plication can prevent the progression of muscle separation and its associated complications.
Benefits and Results
Improved Core Strength
Following recovery, patients typically experience significant improvements in core function. Activities that once proved challenging become manageable, with many reporting enhanced day to day activities and improved exercise performance. The restored muscle alignment also contributes to better posture, reducing strain on the lower back.
Enhanced Abdominal Contour
Beyond functional improvements, muscle plication delivers remarkable aesthetic results. Abdominal wall plication creates a stronger, more stable core structure. The waistline appears more defined, and the abdomen flatter. Many patients find they can wear fitted clothing with greater confidence, and their overall body proportions appear more balanced.
Long-Term Outcomes
Muscle plication results typically last indefinitely when patients maintain a stable weight and healthy lifestyle. Regular core-strengthening exercises can help optimize and maintain results of the abdominal muscle plication repair. Once completely healed, the repair remains intact regardless of activity level.
The Muscle Plication Procedure
Let’s break down exactly what happens during this transformative surgery. It is important to understand each step and set realistic expectations for your journey toward abdominal core restoration.
Pre-Surgery Preparation
Preparation for muscle plication begins weeks before surgery.
A comprehensive medical evaluation with a qualified plastic surgeon is important to ensure that you are an appropriate candidate for the procedure. During your consultation, your questions will be answered and you will be given guidance on how to prepare for surgery to optimize your outcome. Patients must cease smoking at least six weeks prior to surgery and adjust certain medications as directed. Maintaining a stable weight and following a nutrient-rich diet also optimizes healing potential.
Surgical Technique
The procedure typically requires 1-2 hours under general anesthesia.
During the surgery, your surgeon will evaluate the extent of abdominal muscle separation, which often varies along the length of the abdomen. The separation is typically most pronounced around the belly button area.
Modern abdominoplasty techniques have evolved to incorporate advanced muscle repair methods. The abdominal muscle tightening procedure requires precise surgical technique to achieve optimal tension and symmetry.
In cases where the muscle separation is severe, surgical mesh may be required to achieve advanced muscle-tightening surgery protocols. The procedure uses permanent sutures to ensure the muscles remain in their restored position long-term.
Muscle Layer Repair
During the procedure, the weakened or separated abdominal muscles are carefully identified and measured.
Using specialized suture techniques, these muscles are carefully brought together under appropriate tension. The suture material chosen is specifically designed for long-term durability, ensuring the repairs maintain integrity over time.
Combined Procedures
Muscle plication frequently accompanies other aesthetic procedures, particularly abdominoplasty.
When combined with tummy tuck muscle repair, patients experience comprehensive rejuvenation of both the skin and the underlying muscular structure. This comprehensive approach addresses multiple concerns in a single surgical session.
Additional procedures might include liposuction or hernia repair, depending on individual needs. The combination of procedures often provides superior results compared to isolated treatments.
Maximize your transformation with Dr. Lo and his team’s integrated approach, and create comprehensive results that address both muscular structure and aesthetic goals.
Safety Considerations
The success of muscle wall repair surgery depends on proper patient selection and surgical planning. While muscle plication has an excellent safety profile, patient selection for suitability remains important.
Candidates must be in good overall health and have realistic expectations.
Related: Types of Tummy Tucks: Your Guide to an Informed Decision
Recovery and Healing
Timeline for Recovery
The muscle plication recovery process requires patience and adherence to specific post-operative guidelines.
Recovery progresses in phases. The first week requires rest and limited movement. By week two, light activities become possible. Most patients return to work within 2-3 weeks, depending on job requirements. Full exercise routines typically resume after 6-8 weeks, with complete healing occurring over several months.
Post-Surgery Care
Proper post-operative care is essential for optimal results. This includes wearing compression garments, following specific incision care protocols, and attending all scheduled follow-up appointments.
Regular monitoring ensures proper healing and allows for early intervention if needed.
Transform Your Core with Expert Surgical Care
Dr. Adrian Lo‘s expertise in muscle plication has helped countless patients reclaim their confidence and physical capabilities.
Contact our Philadelphia plastic surgery office to schedule your consultation with our award-winning plastic surgeon and discover how muscle plication can help you achieve your goals.
Our team will provide detailed information about the procedure and create a personalized treatment plan aligned with your specific needs.