Painful sex 7 months after tummy tuck - what could it be?

Question

I had an extended tummy tuck, muscle repair and lipo to flanks 7 months ago no issues with healing ...but now that im 7 months out and back to normal for the most part i have noticed it hurts during sex. It feels like im being punched on my insides and every once in a while i felt that pain before but ever since tummy tuck its way worse and it happens 90% of the time during sex...is this nornal? Is it because of scar tissue or what could it be?

J. Timothy Katzen, MD, FACS · Answer

Thank you for reaching out with your concerns about painful intercourse following your tummy tuck procedure.

While it is not uncommon to experience some degree of pain or discomfort during sex after any surgical procedure, it is important to determine the underlying cause of your symptoms. In some cases, scar tissue or adhesions from the tummy tuck procedure can contribute to pain or discomfort during intercourse. This can sometimes be addressed with manual therapy, stretching exercises, or other non-surgical treatments.

However, there are other potential causes of painful intercourse that may be unrelated to your tummy tuck procedure. These can include conditions such as endometriosis, pelvic inflammatory disease, or vaginal infections. It's important to discuss your symptoms with your healthcare provider to determine the most appropriate course of action.

I would recommend scheduling a consultation with your plastic surgeon to discuss your symptoms and undergo a thorough evaluation. They may also refer you to a specialist such as a gynecologist or physical therapist as needed.

Thank you for your question, and I wish you the best of luck in finding relief from your symptoms.

Sincerely,
Dr. Katzen

Daniel Barrett, MD · Answer

Dear ejf91,
I understand your concern. However, without a proper assessment, it would be difficult to determine what went wrong. It is best that you visit your plastic surgeon for further assessment or ask for a second opinion. Only after a thorough examination, you can get proper recommendations and advice.
Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Connie Hiers, MD, FACS · Answer

It is possible that your pubic area was pulled upward when the abdominal skin was pulled downward and this pulling is giving some pain.  Try massaging the pubic skin area to help stretch it some and perhaps try different positions.

Lawrence S. Reed, MD · Answer

It is hard to provide a diagnosis without examining the patient and knowing exactly the type of procedure that was performed. There may be muscular pain as a result of this surgery but it is normally not long lasting. I would ask the patient if she had this symptom earlier or whether it just started happening. 
Complications that lead to pain during sex after abdominoplasty may include scar hypertrophy, scar tissue pain, symptoms related to nerve injury, etc. I would recommend that you have a consultation with your plastic surgeon.

Camille Cash, MD · Answer

I'm sorry to hear about your issues with painful sex.  This is not typical after a tummy tuck.  The external tissue of the mons may have been pulled up during the tummy tuck creating discomfort.  I encourage you to begin by visiting your gynecologist for an examination and discussion of your concerns.

Mark Eberbach, MD · Answer

Sorry to hear of this. This is not a problem specifically related to a tummy tuck. The fact that it was present prior to this surgery suggests it is a preexisting condition that has become worse.

See your gynecologist.

Mats Hagstrom, MD (license on probation) · Answer

In regards to sexual intercourse a tummy tuck can have two major impacts. The skin tension can pull up on the genitals. This is typically more of an aesthetic issue at least no one has to date mentioned it affecting sexual intimacy.Muscle tightening reduces intra-abdominal volume and can increase intra-abdominal pressure. The position of the uterus cervix and vagina are deep in the pelvis and should not be able to be affected from an external abdominal procedure like a tummy tuck.
It’s unlikely any plastic surgeon will be able to be helpful with your situation. Most likely your best option is to discuss this with your OB/GYN as well as having honest discussion with your sexual partner about what is comfortable and what is not.Best,
Mats Hagstrom MD

Jeffrey C. Hamm, MD - Account Suspended · Answer

Hi and welcome to our forum!
Painful sex is not a common problem after abdominoplasty. The surgery itself does not involve the vagina. However, if the pubic skin and soft tissue were advanced upward during the abdominoplasty, it may alter the angle of penetration, and may be responsible for painful sex. 
You should undergo reevaluation by your plastic surgeon as well as by your gynecologist to determine the source of your pain. 
Best wishes...

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