Can I have a tummy tuck with abdominal wall adhesions?

You’re absolutely right to be asking these questions – abdominal wall adhesions, especially from endometriosis or previous surgeries, do complicate the picture. Let’s go through this carefully:
1. Can you have a tummy tuck with abdominal wall adhesions?
Yes, it’s possible – but only with careful surgical planning.
• Adhesions that stick organs (like bowel, bladder, or uterus) to the abdominal wall are a major concern because the dissection involved in a tummy tuck may disturb or accidentally injure those organs.
• Surgeons can encounter adhesions during the procedure and carefully work around or release them, but this increases the risk of complications such as organ injury, bleeding, or infection.
• A combined team approach (plastic surgeon + general or gynecologic surgeon) may be advisable if known or suspected extensive adhesions are present.
2. Is it advisable if the adhesions are from endometriosis or prior surgeries?
It depends on the severity and symptoms:
• If adhesions are extensive and symptomatic (causing pain, bowel issues, etc.), a diagnostic laparoscopy or other imaging might be considered before committing to abdominoplasty.
• A tummy tuck is an elective procedure, so the risk-benefit ratio must be carefully considered. In some cases, it may be safer to address or at least map out the adhesions first.
• Some patients choose to have adhesiolysis (surgical removal of adhesions) as a separate procedure before or during abdominoplasty – this again depends on the extent of the adhesions and symptoms.
3. Will a diastasis recti repair disturb the adhesions?
It can – but not always.
• Diastasis recti repair (usually done with suturing the linea alba) is performed on the front of the abdominal wall, so if adhesions are deeper – on the peritoneal or visceral surfaces – they might not be involved directly.
• However, any surgical manipulation of the abdominal wall risks disturbing nearby adhesions, especially if they’re tethering organs close to the muscle or fascia being repaired.
• Even if existing adhesions aren’t disturbed, new adhesions can form after surgery – this is a known risk with any abdominal operation.
In summary:
• Yes, you can potentially have a tummy tuck, even with adhesions – but you need a surgeon experienced with complex abdominal cases.
• Pre-operative imaging (CT or MRI) may help, but the full extent of adhesions is often only visible during surgery.
• Diastasis recti repair may or may not impact adhesions, depending on their depth and location.
• Yes, more adhesions can form as a result of surgery.
What you can do:
• Seek a plastic surgeon with experience in post-surgical or post-endometriosis cases.
• Request a pre-op imaging study (like MRI with contrast or CT scan) to get a better idea of adhesion location.
• Consider a collaborative approach between plastic surgery and a gynecologist or general surgeon.