Can a Tummy Tuck and Breast Reduction/lift Be Done on a Person with an Ileostomy?

My name is Shannon, I'm 38 y/o. I have had Crohn's for 20 years now, and had to have an emergency, permanent, total colectomy almost a year and a half ago. My abdomen and breasts have not bounced back. My abdomen has a few scars, and quite a bit of fat that prevents my pouches from fitting properly, so they leak almost daily, and my skin around the stoma is in bad shape. My breasts have become very heavy, and saggy, to the point my right breast scrapes the top of my ostomy bag! HELP!!!!

Doctor Answers (9)

Breast Lift and Tummy Tuck with Ileostomy

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   Breast lift can be performed as long as the incisions afterwards will not be at risk for soiling from the ileostomy.   Any meaningful tummy tuck would have to performed in conjunction with a relocation of the ileostomy.


Los Angeles Plastic Surgeon
5.0 out of 5 stars 209 reviews

In a patient with an ileostomy, breast reduction is not problematic but abdominoplasty would be.

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Breast reduction should not be a problem although if your are on any immunosupression, the complication risk would be a bit more.  A don't think an abdominoplasty is contraindicated but it should be done with great caution and might need some modification depending on your specific situation.

Vincent N. Zubowicz, MD
Atlanta Plastic Surgeon
4.5 out of 5 stars 8 reviews

Abdominoplasty around the ileostomy

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Breast Reduction can easily be performed in your situation.  The abdominoplasty around the ileostomy can be a lot more difficult and it really depends upon the amount and location of scars in your abdomen and scarring that you have intra-abdominally.  In addition, this case is going to require coordination with your general surgeon who placed the ileostomy as essentially an entirely new ileostomy will have to be performed.  Good luck.

Sacha Obaid, MD
Dallas Plastic Surgeon
4.5 out of 5 stars 20 reviews

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Surgery with ileostomy?

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This is a great question. First, you could certainly have a breast reduction - no prblem. A standard type of tummy tuck might not be in the cards but some type of modified tummy tuck might be possible. There are some increased risks but they should be manageable. BUT - you need need to find someone very experienced and someone who can think a little outside of the box. Take your time. Good luck.

Ronald Schuster, MD
Baltimore Plastic Surgeon
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Tummy tuck and ileostomy

+1

Breast reduction is possible with some increased risk of infection. I would seriously advise against a tummy tuck in presence of ileostomy. It is almost impossible to perform, and any complications that occur could be devastating to you.

Shahriar Mabourakh, MD, FACS
Sacramento Plastic Surgeon
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Ileostomy and tummy tuck/breast reduction

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Although a breast reduction should be a reasonable procedure to perform on you, a tummy tuck would be a more complex procedure.  Although the complication rate of a tummy tuck with your ileostomy would be high, depending on the location of the ileostomy, it may be possible to perform some type of modified tummy tuck.  A consultation with a board certified plastic surgeon can help determine whether you are a candidate for any tummy tuck procedure.

Arnold S. Breitbart, MD, FACS
Long Island Plastic Surgeon
5.0 out of 5 stars 47 reviews

Abdominoplasty with an existing ileostomy not a good idea

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A breast reduction would be possible given your medical condition.  An abdominoplasty on the other hand would be a big mistake.  The chances for developing an infection are very high and this could even be a life threatening problem.  If you are having problems around the ileostomy stoma because of loose skin then it is possible that the site could be revised or placed in another position.  Contact your general surgeon and let him know the problems that you are having with leakage and skin irritation.  

Jeffrey Zwiren, MD
Atlanta Plastic Surgeon
5.0 out of 5 stars 9 reviews

Tummy Tuck With Ileostomy & Abdominal Scars Ill Advised

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Thank you for your question.  Given your description, a breast reduction would be a reasonable procedure to undertake.  This would reduce and lift your breasts so that they do not reach down to your ileostomy bag.  You should discuss vitamin supplementation if you have had a recent course of steroids to reduce your chances of healing problems.  With respect to your abdomen, it is my opinion that an abdominoplasty would be ill-advised with an ileostomy in place.  The dissection required for a tummy tuck involves lifting the skin of the abdomen up.  This can compromise the blood supply of the abdominal skin when you have surgical scars.  Additionally, the risk of fecal contamination of the wound and space under the skin is too great.  This could lead to a serious wound infection.  An ileostomy was likely created as a result of the emergent nature of your surgery. You should discuss the possiblity of an ileal pouch procedure with your colo-rectal surgeon.  Additionally, ileostomy revision may provide some improvement.  Best of luck.

Robert F. Centeno, MD, FACS
Fairfax Plastic Surgeon
5.0 out of 5 stars 33 reviews

Breast Reduction/Tummy Tuck with Ileostomy in Place?

+1

Thank you for the question.

Based on your description, breast reduction surgery may be an excellent option for you; this operation tends to be one of the most patient pleasing operations we perform.

 On the other hand, the tummy tuck operation may be something of a complex undertaking given your previous surgical history. Without direct examination or (at least) viewing pictures it is hard to say whether the previous scars and/or ileostomy  will make the tummy tuck operation too risky of an endeavor.

The presence of previous abdominal scars and irritated/inflamed skin around the ileostomy site  will  potentially make tummy tuck surgery  difficult ( at best)  or contraindicated;  again, much will depend on direct physical examination.

 At some point, you may benefit from in-person consultation with board-certified plastic surgeons.

Best wishes.

Tom J. Pousti, MD, FACS
San Diego Plastic Surgeon
5.0 out of 5 stars 726 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.