What are my options for repair of recti diastasis and lower belly bulge after congenital heart disease operation?

Question

My heart disease scar runs horizontally across my entire breast line. I am fit, healthy and non smoker/drinker. I have a generous 3 finger width recti diastasis and fat on the lower belly. It's not major but gives me that early pregnancy look & I have stretch marks in my lower belly. I understand that a typical tummy tuck is not suitable due to lack of blood supply from the top. Would a reverse tuck be able to fix the recti and does this mean my stretch marks would lift to all over my stomach

Joubin Gabbay, MD · Answer

Yours is certainly a challenging situation, but by no mean precludes you from getting a tummy tuck. An incision such as the one you have may compromise the blood flow to abdominal flap used in the tummy tuck, but after so long a time after your operation, have reestablished bloodflow in the area. Your options may include a standard tummy tuck or what is Colby reverse abdominoplasty where the skin flap brought up rather than down.I recommend that you seek the advice of a surgeon who is very experienced in abdominoplasty. I wish you the best.Dr. Gabbay.

Robert Drielsma, MBBS, BSc, FRACS · Answer

Thanks for your enquiry.  By the sounds of it you may be a good candidate for a combination of a reverse abdominoplasty where your previous breast line scar can be used to lift and tighten upper abdominal skin, and a lower mini abdominoplasty technique to tighten lower abdominal skin.   Your rectus diastasis can be repaired with this approach.  I have used this approach on many patients now with satisfying results. You need a formal consultation with a fully qualified plastic surgeon who has experience in this uncommon surgical approach to determine your suitability for surgery.

Sugene Kim, MD, FACS · Answer

Hi, flygirlonline.  Thanks for your question.  Depending on how long ago you had undergone congenital heart surgery, the blood flow may have been re-established.  Your plastic surgeon can perform radiographic study (such as CT angiogram) to see your blood flow of the abdominal wall.  Please consult an experienced, board-certified plastic surgeon.  Best regards.

Neil T. Chen, MD · Answer

Thank you for your question. From your description, we have assume the blood supply to the rectus muscles and to the skin flap may be compromised. Reversed tummy tuck will reduce the concern of the blood supply issue. However, from what you described, the lower abdomen probably will need more tightening than the upper. I think a better option may be limited (mini) tummy tuck, where the elevation of skin is limited to the area below the umbilicus. Discuss with your surgeon about this and good luck.

What are my options for repair of recti diastasis and lower belly bulge after congenital heart disease operation?

Answers (4)

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