How to find a surgeon who will perform an endoscopic tummy tuck?

Question

I’ve contacted a few plastic surgeons in my area and they don’t perform endoscopic tummy tucks. I don’t have any fat or loose skin but my stomach does pop out. I look extremely bloated. I believe this is caused by my diastasis recti. My stomach feels hard and it’s uncomfortable. I also have a lot of lower back pain. I had my second baby 18 months ago and it’s not getting better. Any recommendations for finding a surgeon who’ll perform this surgery?

J. Timothy Katzen, MD, FACS · Answer

Thank you for your question regarding the search for a surgeon who performs endoscopic tummy tucks. Based on your description, it appears that you have diastasis recti, which is causing your abdomen to protrude and leading to discomfort and lower back pain. An endoscopic tummy tuck, which involves repairing the separated abdominal muscles through small incisions with minimal scarring, could be an appropriate solution for you.

To find a qualified surgeon who offers this procedure, consider the following steps:

Research Specialized Plastic Surgeons: Look for board-certified plastic surgeons who specialize in minimally invasive abdominal procedures. You can start by searching through professional organizations such as the American Society of Plastic Surgeons (ASPS) or the American Society for Aesthetic Plastic Surgery (ASAPS), which have directories of certified surgeons.

Consultation: Schedule consultations with potential surgeons to discuss your specific condition and determine if an endoscopic tummy tuck is the best option for you. During these consultations, inquire about the surgeon's experience with the procedure, view before-and-after photos of previous patients, and ask about the expected outcomes and recovery process.

Seek Recommendations: Ask for referrals from your primary care physician, obstetrician, or friends who have undergone similar procedures. Personal recommendations can provide valuable insights into a surgeon's expertise and patient care.

Consider Travel: If local surgeons do not offer endoscopic tummy tucks, you might need to consider traveling to a nearby city or state where experienced surgeons are available. Ensure that the potential benefits outweigh the inconvenience and costs associated with travel.

By taking these steps, you can find a qualified surgeon who can address your diastasis recti and help alleviate your symptoms. Remember to thoroughly vet any surgeon's credentials and experience to ensure you receive the best possible care.

Sincerely,
Dr. Katzen

Christopher Pannucci, MD, MS · Answer

Hi mjorge82,
Based on your description, it seems like you are interested in a laparoscopic or robotic repair of rectus diastasis, which is a vertical split between your six pack muscles. A robotic or laparoscopic approach is not part of a standard tummy tuck, as both the training and equipment necessary to do so are different.
Plastic surgeons will perform tummy tuck to address 3 distinct things. Standard tummy tuck, done from the face up position, typically would include removal of excess skin and fat below the belly button, liposuction of the flanks to improve contour, and rectus plication, which is a tightening of the abdominal wall to fix a gap between the 6 pack muscles. This essentially produces an internal corset.
You are describing a minimally invasive approach to repair rectus diastases that does not involve skin excision. This is potentially possible using a laparoscopic or robotic approach. From the insurance perspective, some general surgeons can repair an umbilical hernia and then perform a more limited robotic rectus plication to reinforce that repair. I am not aware of any general surgeons doing a robotic (full vertical) rectus repair on a self-pay basis. if you are looking for a surgeon, based on your concerns you should be looking for a surgeon who does robotic or laparoscopic surgery, especially for hernia repair, who also would be able to take an out-of-pocket pay patient.
I think that the most straightforward way to find a surgeon would be to have an initial evaluation by a board certified plastic surgeon, who could determine whether a standard tummy tuck as described above would be an appropriate operation for you. This would include not only rectus muscle plication, but removal of excess lower abdominal skin and fat.
Hope this helps.
Best,Christopher Pannucci MDBoard Certified Plastic SurgeonPlastic Surgery NorthwestSpokane, Washington

Gerald Minniti, MD, FACS · Answer

There will be skin excess after your diastasis recti is repaired. If your pregnancy led to diastasis, then it also expanded your skin making it less apt to elastically contract, giving you a functional skin excess.

Daniel Barrett, MD · Answer

Dear mjorge82,
finding the right Dr. is extremely challenging especially with the number of online platforms and resources available. There a lot of great Dr's available. Make sure he/she is a board-certified plastic surgeon. Definitely check to make sure your choice specializes in the procedure you want and spend the time to read through patient testimonials. There is a number of different sites where you can check for reviews (Realself, yelp, google, etc.).You can always pick up the phone and call around also, find an office you feel comfortable with and set up a few consultations. 
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

If your problem is just weak abdominal muscles and you have no food allergies to cause the swelling, you might consider EMSculpt to tighten your muscles and bring the stretched muscles back together. With hardness and bloating, it sounds more like food allergies.

Camille Cash, MD · Answer

Have you visited with a board certified plastic surgeon for an evaluation?  You may have more loose skin than you think, especially after diastasis repair, and will benefit from a more standard approach to a tummy tuck.  I encourage you to find out more before making a final decision.

Mats Hagstrom, MD (license on probation) · Answer

Endoscopic muscle tightening does not work well.
The strength layer of the abdominal wall is the muscle fascia which is between the fat and muscle anatomically.
I’ve never seen a good outcome from this attempted laparoscopically.
Well that muscle tightening will also distort the anatomy which requires re-draping the skin and fat layer so it doesn’t bulge in the midline.
There’s a reason this procedure is not performed regularly. The reason is because it doesn’t work well.
There are two indications to have a tummy tuck. One is abdominal skin laxity and the other is muscle separation from previous pregnancies.
You can have a full tummy tuck to treat one or the other or both.
Best,
Mats Hagstrom MD

Jeffrey C. Hamm, MD - Account Suspended · Answer

Hi and welcome to our forum!
Is the bloating the cause or the effect of the problem? Diastasis recti is usually asymptomatic. Your symptoms suggest that a gastrointestinal problem may be involved and is at least partially responsible for your distress. 
I would recommend evaluation and treatment by a gastroenterologist before considering a surgical "cure". 
One the bloating is controlled, one can then address lax tissues if it is still required. Look up "endoscopic abdominoplasty" on the internet to determine where resources are available.
Best wishes...

How to find a surgeon who will perform an endoscopic tummy tuck?

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