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Is It Too Much of a Risk to Combine a Full Tummy Tuck with a Partial Hysterectomy? (photo)

I am 43 and scheduled to have a partial hysterectomy due to severe pain and prolonged bleeding from fibroids. I was 240 lbs, lost down to 147 at my smallest. Now I am 175. I consulted with a PS to have a fully tummy tuck but was told that it would be to traumatic on my body and to only have a mini to remove the excess skin and fat under my belly button (which I call my shelf). My concern is that a mini TT will leave me with an odd looking waistline.

Doctor Answers (20)

Combine a Full Tummy Tuck with a Partial Hysterectomy?

+2

I completely agree with you in saying that a mini TT will leave a very unsatisfying result. I don't see the added risk of doing a full TT if your surgeon is already considering a mini-TT. Physiologically, the full TT doesn't add much time or risk compared with a mini. 

This is a fairly common combination of procedures, though it is not for every patient. If you have any heart or lung issues it may be better to do these separately. If you have a tendency to have abnormal blood clotting, your best bet may be separating the procedures. If either of your surgeons is particularly slow, it may also be better to do the operations in stages (hysterectomy first). 

You might consider checking with your OB-Gyn about getting another opinion from a different plastic surgeon. 

Thanks for the question, best wishes.


Seattle Plastic Surgeon
4.5 out of 5 stars 31 reviews

Tummy tuck

+2

You need a full tummy tuck done.  A mini tuck will leave you with a disappointing result.  I have performed a tummy tuck at the same time as a hysterectomy and  they can be safely combined in most cases.  However, studies have shown a higher incidence of complications, especially blood clots, in combiined procedures.  I would not ask your surgeon to perform an operation that he or she does not feel comfortable performing.  Younmight want to discuss it with. Your surgeon again to see what options are available in your particular situation.

Ronald J. Edelson, MD
San Diego Plastic Surgeon
5.0 out of 5 stars 8 reviews

Too risky to combine tummy tuck and partial hysterectomy?

+2

Yes it is. The uterus is not a sterile organ. Contamination of the tummy tuck could cause fatal sepsis. Patients push their doctors to do such risky things to save money. We have our own JCAHO inspected operating room and I have been doing my own anesthesia for over 30 years with a perfect safety record. This saves around $3000 per surgery and eliminates the urge to combine procedures. The incidence of complications begins to double for every hour of surgery over 2 hrs. Leg vein blood clots that break off and go to the lungs occur with every surgery under general anesthesia over 4 hrs in length and tummy tuck is the most risky surgery of all for that. We have never had a DVT/PE after a tummy tuck because of our type of anesthesia, short operative time and early ambulation. PEs can be fatal. Don't chance it with that kind of risk.  'nuff said?

Dr Foster  Lake Tahoe Plastic Surgery

Lawrence Foster, MD
Sacramento Plastic Surgeon
3.0 out of 5 stars 12 reviews

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Partial Hysterectomy at the time of Tummy Tuck

+2

Tummy tuck and hysterectomy each carry a certain amount of risk, which is acceptable when done alone. However, when the two procedures are combined together, these risks are increased and are beyond what I consider to be acceptable for an elective operation. The risks include Deep Venous thrombosis, infection, and bleeding among others, all of which are increased when the two procedures are combined.

 

You would benefit most from a full tummy tuck to get the desired contour and shape. Ideally, you would do the tummy procedure second, once you have healed from the partial hysterectomy operation.

Ramin Behmand, MD
San Francisco Plastic Surgeon
5.0 out of 5 stars 10 reviews

Tummy Tuck and Hysterectomy

+2

From your photos, it appears that you need a full tummy tuck and a mini will not produce an ideal result. If you have had significant issues with your fibroids, I would consider staging the procedures since there may be issues with your hysterectomy that could complicate your surgery. I would not embark on less of a surgery just to get the procedures done more quickly. Get a second opinion as this is a more complicated question and needs to be addressed in person.

Best of luck

Vincent Marin, MD

Vincent P. Marin, MD
San Diego Plastic Surgeon
5.0 out of 5 stars 26 reviews

Hysterectomy and Tummy Tuck

+2

I am also of the opinion that these to operations should be done at a separate time.  The concerns I have would be the potential complications with a prolonged operation in regards to DVT, blood loss,  and potential for bowel injury.  All of theses factors are can occur with abdominoplasty and hysterectomy but are more likely when hysterectomy is performed.  I would recommend getting your gynecologic issues solved prior to seeking aesthetic correction of your abdomen.

 

Dr. ES

Earl Stephenson, Jr., MD, DDS
Atlanta Plastic Surgeon
5.0 out of 5 stars 8 reviews

Full abdominoplasty will give you the best result, but I recommend separating this from the hysterectomy

+2

The question you raise about the benefits of a "mini" abdominplasty (I prefer the proper anatomical term of "lower" abdominoplasty, as no operation of this extent is "mini" in my opinion) vs. full abdominoplasty is an excellent question.  For each patient, a discussion of the patients complaints, expectations, history of weight fluctuation and previous abdominal surgery will play a large role in planning which operation is the best for the individual patient.  A thorough examination of the anatomical components of the abdominal wall is essential-the skin laxity (upper vs. lower abdomen), amount of fat, and presence of abdominal wall muscle laxity/rectus muscle diastasis is vital to plan the correct anatomical operation for each patient.  

Your anatomy, based only on the photographs you provide, suggests that you would benefit from a full abdominoplasty.  There is upper and lower abdominal wall laxity and striae (stretch marks) and presumably there is relaxation of the abdominal muscular wall.  All of these abdominal wall physical findings will be best addressed with a full abominoplasty.

In my practice, I have felt it is best to separate any intra-abdominal surgery (surgery that enters the cavity where the abdominal organs are located) from any elective cosmetic plastic surgery of the abdominal wall, i.e.., abdominoplasty.  I become concerned about an increased incidence of bleeding or infection, increase in operative time and recovery and associated morbid sequelae such as deep vein thrombosis and pulmonary embolism.  It is for this reason that I recommend separating the intra-abdominal surgery (hysterectomy) from the abdominoplasty.

I hope this helps to explain the reason for my recommendations.  Good luck to you in your decision making.

Christine Petti, M.D., F.A.C.S.

Christine A. Petti, MD
Los Angeles Plastic Surgeon
4.0 out of 5 stars 13 reviews

Full tummy tuck will give you the best result

+2

Hello,

It is not uncommon to combine surgical procedures.  Some are well worth doing like breast and tummy tuck others may be best done separately.  I think a partial hysterectomy and a full tummy tuck would be one of those combinations that are best performed separately.  When undergoing a full tummy tuck you want the best result possible.  To do so, swelling, weight, volume, etc would be better assessed later after your hysterectomy.  You will inevitably get different answers from different plastic surgeons but in general it is better to focus on the tummy tuck portion of your case separately.  Also, from your photos it would appear that you would be a better candidate for a full tummy tuck as opposed to a mini tummy tuck.

All the best,

Dr Remus Repta

Remus Repta, MD
Scottsdale Plastic Surgeon
5.0 out of 5 stars 89 reviews

You can get full tummy tuck with hysterectomy.

+2

As long as you are healthy, you should be able to undergo abdominoplasty (tummy tuck) with hysterectomy.  I have done many abdominoplasty with hysterectomy without problems.  

In regards to mini-tummy tuck vs. full tummy tuck, the full tummy tuck will give you a better result.  The full tummy tuck will address excess skin, excess fat, and lax upper and lower abdominal muscle better.  As you stated, a mini-TT will give you a limited result.

Sugene Kim, MD
Houston Plastic Surgeon
4.5 out of 5 stars 37 reviews

Mini or Full Tummy Tuck?

+2

Thank you for the question and pictures. Although the pictures are somewhat limited, I think it is clear that a mini tummy talk will leave you with a very limited (if any)  improvement.

Generally speaking, inmy opinion, the mini tummy tuck is an  operation that  produces very limited results and is very rarely indicated. It involves a shorter incision but does not address the majority of the abdominal wall issues present for most patients who present consultation. For example, the area of skin excised is quite small. The abdominal wall musculature is addressed below the umbilicus leaving the upper number wall potentially lax. The appearance of the umbilicus is not necessarily addressed sufficiently.

For most patients who have had pregnancies and/or weight loss a full abdominoplasty is necessary to achieve the desired results. Of course, there are downsides (including a longer scar and probably a longer recovery time) but for most patients the benefits outweigh the downsides. It is not unusual to see patients who've had mini tummy tuck  surgery present for  revisionary surgery.
It is important  for patients seeking abdominal contouring surgery to work with a well experienced board-certified plastic surgeon to obtain advice (based on good ethics and judgment) to  improve  their chances of a successful outcome and minimize the need for further surgery.


Be very careful about combining surgical procedures. Make sure you are working with well experienced board-certified physicians who can expedite the operation and work together to minimize the potential for complications.
 

 Best wishes.

Tom J. Pousti, MD, FACS
San Diego Plastic Surgeon
5.0 out of 5 stars 710 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.