Should I wait to have my Panniculectomy until after another pregnancy?

Question

I had gastric bypass in 2019 which left me with a lot of hanging skin. Got pregnant in 2020 and had a very complicated pregnancy and imaging was difficult due to the excess skin. I ultimately went to premature labor and had to have an emergency C-section. After which I got a severe infection in my C-section scar due to the hanging skin I’m contemplating having another child but I’m unsure if I should wait to have my skin removal Until after another baby due to my high risk status

Randal Haworth, MD, FACS · Answer

It's understandable that you are unsure about the best course of action regarding skin removal surgery and planning for another pregnancy. It's important to keep in mind that the risks associated with pregnancy and childbirth can be higher for women who have had gastric bypass surgery and for those who have excess skin or have undergone skin removal surgery.

Before making any decisions, it's recommended that you consult with both your bariatric surgeon and a board-certified plastic surgeon who specializes in body contouring surgeries after massive weight loss. They can provide personalized recommendations based on your specific health history and current condition.

In general, it's recommended that women wait at least 12-18 months after weight loss surgery before becoming pregnant, to allow for adequate weight stabilization and to reduce the risk of complications during pregnancy. Additionally, it's recommended to wait at least 6-12 months after childbirth before undergoing any elective surgery to allow for the body to fully recover.

If you do decide to undergo skin removal surgery before another pregnancy, it's important to discuss the potential impact of the surgery on future pregnancies with your surgeon. They can provide guidance on when it may be safe to become pregnant after surgery and what steps you can take to minimize any risks.

Ultimately, the decision of when to have skin removal surgery and when to plan for another pregnancy is a personal one that should be made with the guidance of your healthcare team.

Best of luck !

J. Timothy Katzen, MD, FACS · Answer

Dear Apruitt0114,

Navigating the decision on when to have a panniculectomy amidst considerations of future pregnancies, especially following your significant weight loss and the challenges experienced during your last pregnancy, is indeed complex. Given the complications you've described, including the severe infection post-C-section attributed to excess skin, the timing of skin removal surgery warrants careful consideration.

If you are uncertain about when you might plan another pregnancy, opting for a panniculectomy sooner rather than later could be beneficial for several reasons. Primarily, removing the excess skin can alleviate physical discomfort and reduce the risk of complications like infections, particularly in areas where skin overlaps. In terms of imaging and medical monitoring during any future pregnancy, having the panniculectomy done could also facilitate easier access and clearer imaging, potentially reducing some of the challenges you faced previously.

Concerning the impact of future pregnancies on the results of a panniculectomy, it's reassuring to note that many patients maintain their post-surgical outcomes even after pregnancy. The abdominal area's ability to "snap back" post-pregnancy can be surprisingly resilient, especially when the panniculectomy is performed by an experienced surgeon who prioritizes not only the removal of excess skin but also the structural support of the abdominal area.

It's worth mentioning that I've never had a patient need to return for corrective surgery post-pregnancy after either a tummy tuck or panniculectomy. The results have generally held up well, with patients reporting satisfaction with their stomachs' appearance and resilience after giving birth.

However, each individual's body reacts differently to pregnancy, and various factors, including the nature of the skin, the extent of the panniculectomy, and overall skin elasticity, will play a role in the long-term outcome post-pregnancy.

Engaging in a detailed discussion with a board-certified plastic surgeon who has experience in body contouring procedures post-weight loss and pregnancy can provide you with tailored advice. They can assess your specific situation, discuss your family planning goals, and help you make an informed decision that aligns with your health, aesthetic goals, and timing for potential future pregnancies.

The goal is to ensure that you feel comfortable and confident in your decision, balancing the benefits of proceeding with the surgery sooner against any considerations for the future.

Sincerely,

J. Timothy Katzen, MD, FASMBS, FICS
Plastic and Aesthetic Surgeon

Gary M. Horndeski, MD · Answer

No, if you are able to do the panniculectomy now then do it.  This will make future c-sections much safer.

Best Wishes,

Gary Horndeski, M.D.

Zoran Potparic, MD · Answer

That question depends entirely of you; removing large pannus that you may have will make your life style very different. With next pregnancy you do not have to gain so much wait to need another TT. In person consultation with a board certified plastic surgeon would give you an optortunity to discuss these issues in more detail. Good luck.

Camille Cash, MD · Answer

Typically it's recommended to wait until you have completed your family to have surgery since you are intending another pregnancy soon.  Your description of your history however warrants a visit with your surgeon to discuss your unique circumstance.  She/He will be better able to advise you.

Should I wait to have my Panniculectomy until after another pregnancy?

Answers (5)

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