Tummy Tuck Revision to Fix Belly Button and Bulge?

Question

I am 5 months post-op from Tummy Tuck, diastasis recti, and hernia repair. Not only do I look the same as I did pre-surgery, but now my belly button is disfigured, have "dog ears", large scar and pain.

I feel like my intestines push up against mesh inside and when I eat or sit I get a bulge in a 5x5 area around my belly button which hurts and burns. This surgery was done to re-build my stomach wall to help aid in supporting my very bad back. I have no stomach muscle strength.

Sean Younai, MD, FACS · Answer

It seams that you still have significant skin redundancy and you can pinch much lower abdominal skin. Also, I do agree that your abodminal wall is weak. Not knowing your full medical/surgical history, I recommend to have your surgeon evaluate you for revision abdominoplasty.

Jed H. Horowitz, MD, FACS · Answer

#TummyTuckRevision surgery It is difficult to tell from your photos and story exactly what was done but revision would probably help youRevision surgery is unusual but may be desired for several reasons. Most revisions should be done after 9-12 months.  One cause for revision surgery are “dog ears” at the ends of the incisions. These are small folds of excess skin that do not flatten over time.  They can be excised, suctioned or both.Excess fat or loose skin may require liposuction and skin excision to obtain the best result.

Richard J. Bruneteau, MD · Answer

Its normal to have some swelling
following abdominoplasty, but swelling of this magnitude five months following
surgery suggest a structural abnormality of the abdominal
wall.  In this situation a
comprehensive evaluation should be undertaken to determine the cause of the
problem.

It’s important that you return to
your original surgeon for an evaluation. 
This evaluation might require a CT scan to evaluate the integrity of the
abdominal wall.  In light of the
fact that mesh was utilized there’s a good chance that this has become detached
from the abdominal tissue.  Under
these circumstances, surgical revision might necessary to correct this problem.

Otto Joseph Placik, MD · Answer

Have you discussed this with your surgeon(s)? I am sure that this is very upsetting to you. It appears that your muscles have separated but this is an opinion based on very limited information. You may need a more complex operation called a separation of parts but It may be worth attemptinfg the muscle repair one more time.

Daniel Kaufman, MD, FACS · Answer

Thank you for your question. It is difficult, if not impossible, to determine the adequacy of your results since you do not supply any preoperative photos to which to compare. From the picture you did sent it does look like you have an unusual appearance to the belly button, and you demonstrate very clearly that you have persistent rolls of fat that you can pinch along the incision. Additionally, from the verbal description of your surgery, it seems that you did not have a routine cosmetic abdominoplasty, but a more complicated abdominal wall reconstruction. The hernia and diastasis recti repairs can be done with sutures only, or with additional mesh - I am not clear on whether mesh was or was not used. Regardless of technique used for this repair, persistent pain is not an uncommon complaint. My suggestion is to obtain a copy of the medical record, specifically the operative report or dictation, as well as the preoperative photos. You should then address the issue with your surgeon, and if you are unhappy with his/her assessment then go ahead and visit with a Board-certified plastic surgeon to get a formal and bonafide medical opinion. Hope that this helps. Good luck and fare well.

Francesco Campanile, MD · Answer

I agree
with what others here have said: your improvements should be more apparent by
five months after surgery. Your first step should be to contact your surgeon
about your concerns. However, don’t feel like you need to stick with him or her
for your revision, especially if you’re not confident that your surgeon will be
able to deliver positive results the second time around either. Instead, take
the time to find a board-certified plastic surgeon with plenty of experience in
tummy tuck revisions, as the second surgery is often more technically
challenging than the first. In many cases, insurance may pay for your revision
surgery as well.

Garrett A. Wirth, MD, MS, FACS · Answer

From your description, I am concerned that you have had a hernia repair and a recurrent hernia.  I am in agreement that you should work with a Plastic Surgeon that does a lot of abdominal wall reconstruction.For more information, please go to my website at:WirthPlasticSurgery.com

Jeffrey Zwiren, MD · Answer

It would be good to see your pre-operative photos. You do not appear to have a normal result from an abdominoplasty. It is also not very common to have to use mesh to repair the abdominal wall fascia. You may need to be seen by an experienced plastic surgeon who can perform an exam and review your previous operative note.

Tom J. Pousti, MD · Answer

Based on your pictures revisionary surgery or more accurately abdominal wall reconstruction is necessary. This would likely involve repair of any diastasis recti or hernia present. Further skin/adipose  tissue excision of the flank and back areas may be necessary to improve contour and eliminate &ldquo;dog ears".

	Seek consultation with a well-trained experienced board-certified plastic surgeon. Best wishes.

John P. Di Saia, MD · Answer

Hello,

	 

	Revision is harder than the original operation. It looks like you should be able to get some improvement, but if you mean by "fix" that everything will be entirely corrected, I would say no. You need a good evaluation by a qualified surgeon to assess what has happened and what might be done to improve it. Listen before you jump into more surgery.

	 

	Best Regards,

	 

	John Di Saia MD

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