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More Questions About Whether an Obese Person W/ history of Abdominal Surgeries Can Have an Abdominoplasty?

Last weekend I went to the ER as my abdomen appeared to shift alot in a short period of time. I didn't want to take any chances, given my hx. They did a ct scan, which revealed a large ventral hernia in my lower left abdomen. I forgot to post that my weight is around 360-370. Is it still possible to have this surgery safely? I would think it would be best to fix this now, rather than wait for an emergency. The md who did last year's surgery won't do it again because of my weight. Help!

Doctor Answers (11)

Abdominoplasty in the obese patient

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The thicker the fat layer in the patient the greater the chance of having a surgical complication.  Healling issues, infections, fluid collections and other issues are much more prevelant in the obese patient.  My phylosophy is that surgery should not be a substitute for diet and exercise.

Miami Plastic Surgeon
5.0 out of 5 stars 1 review

Abdominoplasty is high risk for complications and failure in obese patients

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Hi there-

While I empathize with your problems, it would be irresponsible for any surgeon to recommend abdominoplasty to you. 

Let me say that another way- even if you found someone willing to do a tummy tuck on you, and even if they were willing to do it for free, the best thing you could do would be to run away from them as fast as you can...

The reason you are not having success finding one of us eager to do a tummy tuck on you is because the facts are that it would be very dangerous to your health, and the chances of a successful and pleasing outcome would be exceedingly low.

The best thing I could do for you would be to be completely honest and blunt- you need to lose weight, and you need to have your hernia addressed. Once these more significant health problems have been managed, you may be a candidate for body contouring surgery- but not until then.

Web reference: http://www.DrArmandoSoto.com

Orlando Plastic Surgeon
4.5 out of 5 stars 82 reviews

Please don't consider a tummy tuck, even if you find someone who will do this. You need bariatric surgery.

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If your health is deemed appropriate for elective tummy tuck surgery, then you should absolutely consider bariatric surgery first. You are morbidly obese, and your general health is at risk. You are not presently a candidate for cosmetic surgery, but can certainly become so after massive weight loss.

Others have been more oblique in stating this, but abdominoplasty is not a weight loss operation, and even hernia repair, which could become urgent or necessary, is potentially dangerous and likely to fail in a patient with your risk factors.

Please, for your own sake, obtain consultation with one or more bariatric general surgeons and discuss your options for weight loss surgery in coordination with addressing your ventral hernia. If your hernia is not "forcing" urgent surgery to prevent serious health risks from the hernia itself, you need your next operation to be the one that restores your health by causing massive weight loss. Then, hernia repair can actually work, and may even be appropriate for repair at the time of abdominoplasty or circumferential beltlift surgery.

Good luck and best wishes! Dr. Tholen

Web reference: http://www.mpsmn.com/body-procedures/lower-body-lift

Minneapolis Plastic Surgeon
5.0 out of 5 stars 91 reviews

Ventral hernia and tummy tuck in the obese patient

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If your hernia is symptomatic, then it may require repair.  However, given your weight, you should consider a weight loss program.  I would not consider you a candidate for abdominoplasty at this time.

New York Plastic Surgeon
5.0 out of 5 stars 8 reviews

Abdominoplasty and ventral hernia repair in obese patients

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Based on the issues you've raised (obesity, recurrent ventral hernia) - I think its important to get the root cause of your problem addressed first : your obesity. Weight and obesity have a propensity to cause ventral hernia and contribute to their recurrence once repaired. Consider losing a substantial amount of weight through diet, exercise and/or bariatric surgery. See if you primary care physician can refer you to a good medical weight loss program.

Seattle Plastic Surgeon
4.5 out of 5 stars 32 reviews

Overweight limit to any concomitant surgery/ el sobre peso limta cualquier cirugia adicional a la abdominal

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you only  should correct specifically this herniae in this moment perhaps with a marlex net, and forget any another kind of surgery by the moment .up you get  your normal weight.

tu requieres corregirte la hernia  ahora exclusivamente quiza hasta con una red  de marlex y hasta que no estes en tu peso normal pensar en otro tipo de procedimiento

Mexico Plastic Surgeon

Large ventral hernia. Safe to perform tummy tuck?

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Dear dianajune,

I would advise that you consult with an experienced hernia surgeon (general surgeon) to fix your recurrent ventral hernia prior to abdominoplasty.  Occasionally, the general surgeon will illicit the help of a plastic surgeon to design flaps of abdominal muscle to help close the hernia.  Unfortunately, the surgical exposure required for the hernia repair can cut off blood supply to the skin that is necessary for proper healing after abdominoplasty.  Given this risk, and your high weight (which already adds increased wound healing, seroma, and blood clotting risks), I would recommend postponing the abdominoplasty until the hernia is repaired.  Weight loss would also significantly improve your candidacy for abdominoplasty and decrease your risks.  Good luck!

Fort Worth Plastic Surgeon
5.0 out of 5 stars 27 reviews

Tummy tuck with a large abdominal hernia

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Sometimes the risk is just too much to consider tummy tuck a safe bet. With the large ventral hernia which is recurrent and even your general surgeon is reluctant to repair given your weight is a big red flag. First things first, weight loss, better health, fix the hernia, and tummy tuck as the last step.

Web reference: http://www.peterejohnsonmd.com/tummy-tuck

Chicago Plastic Surgeon
4.0 out of 5 stars 25 reviews

Safety of TT with large hernia repair.

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I would have to pass on the analysis of risks and benefit evaluation to an experienced hernia surgeon.

Not treating this  has risks of the complication of surgery--strangulation, and addressing that complication is a much more serious issue than fixing the hernia in an elective setting. As you already know from your own experience, fixing the hernia has no guarantee of success. 

Fixing this large a hernia is already a big deal operation, and adding a tummy tuck to that adds extra risk--almost any tummy tuck wound complication will sabotage the hernia repair. That would best be done after the hernia is fixed. 

I don't know if you have ever considered weight loss surgery. Losing weight would give you the best outcome for the hernia repair and any abdominoplasty or panniculectomy that might be recommended. I might add that the weight loss surgeons are often quite experienced with the large hernias associated with obesity. If you have trouble finding a surgeon in you vicinity, try the nearest university hospital department of surgery.

Thanks for your question, and best wishes. 

Seattle Plastic Surgeon
4.5 out of 5 stars 28 reviews

Obesity and Abdominal surgery

+1

I didn't see your original post but I have some things to suggest.

 

It would be the domain of the general surgeon to determine timing and technique of hernia repair, in consultation with you.

 

One of the problems is that with all that intra-abdominal weight, the success of surgical repair of hernia is severely compromised- high risk of recurrence. 

 

I don't know your height, BMI, or other important health issues.  You may want to consult with a bariatric surgeon and get your weight down to a healthy level first.  Then if prudent, go for the hernia repair.  An abdominoplasty may be possible at the same time.

 

If I were you, I would get all information and options on the table before I made a decision.

 

Best of luck.

 

sek

Dallas Plastic Surgeon
4.5 out of 5 stars 44 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.