Am I a candidate for a tummy tuck if I had 2 previous incisional hernias (AWR) with mesh? (Photo)

Question

Tummy Tuck possible after having AWR with mesh due to an incisional hernia?

Harry T. Haramis, MD, FACS · Answer

A tummy tuck is possible after hernia repair with mesh, provided you would benefit.

You appear to have internal fat which is not treatable with a tummy tuck. That requires diet and exercise to reduce the roundness inside. A tummy tuck will only address hanging skin and weakened muscles, which you do not appear to have.

An exam and consultation with a plastic surgeon is recommended to confirm this as well as discuss your options.

Finny George, MD · Answer

Hi, thank you for sharing your question. You may still be a candidate for tummy tuck based on the details found in your operative note from the hernia repair.

Daniel Barrett, MD · Answer

Dear SnatchThis,
it is hard to tell for sure without an examination. If you are considering surgery, I would suggest you consult a board-certified plastic surgeon. Only after a thorough examination, you will get more information and recommendations.
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

You may be an excellent candidate, but you did not show your whole abdomen. With the mesh for hernias present, the muscle work may not be done, but you can get the skin tightening.

Leo McCafferty, MD · Answer

Thank you for your question and it is a good one.  It is hard to tell from the photo you provided whether you would be a candidate but certain patients that have had hernia repair with and without mesh may have an abdominoplasty.  I would recommend that you attempt to coordinate this with your plastic surgery and also consult with your general surgeon that repaired the hernia. The more information your plastic surgeon has regarding your previous hernia repair the safer the procedure will be for you.  Good luck.

Camille Cash, MD · Answer

Based on the information you've provided you may be at higher risk if you undergo a tummy tuck.  I encourage you to visit with a few board certified plastic surgeons to hear varying opinions and learn more about potential options for you.

Kenneth R. Francis, MD, FACS · Answer

Dear SnatchThis,
After 2 mesh abdominal hernia repairs you would most likely be at a very high risk for a tummy tuck.  You are better off with weight loss.  Good luck!

Robert Singer, MD · Answer

It is difficult to tell whether you are a good candidate without a physical examination and complete medical history. Generally, prior hernia repair with mesh should not be a contraindication to having a tummy tuck.
 
Weight within 10 pounds of your ideal should not have any effect on your long term results.

If a member of my family underwent these procedures, they would be performed by an experienced plastic surgeon who is board certified by the American Board of Plastic Surgery and a member of the American Society for Aesthetic Plastic Surgery and the American Society of Plastic Surgeons. If you are serious about undergoing these procedures, you should have a thorough consultation with a plastic surgeon having those credentials, who will fully explain what is entailed in the procedures, including both the positives and potential problems. You should be complimented on the fact that you are seeking valid information before jumping into any procedure.

Robert Singer, MD  FACS

LajOlla, California

Douglas Taranow, DO, FACOS · Answer

While excess abdominal skin may be removed, I would need to examine you to assess if tightening of the muscles is feasible 
Best wishes 
Dr. Taranow

Mats Hagstrom, MD (license on probation) · Answer

Having had previous hernia repairs with or without mesh and having a midline incision should not prevent you from having a successful full tummy tuck.
Discard tissue in your current scar Volac pliability and not stretch like virgin skin on either side of it. The best comparison is think of the scar tissue as being like a string while the skin and fat layer behave like a rubber band.
In order to pull the skin tight the rigid scar tissue needs to be removed in conjunction with the tummy tuck. it’s really important that you discuss this with the surgeon and there’s a clear understanding that the midline scar will be exercised and re-formed during the procedure.
An attempt at doing the tummy tuck with your current scar will seriously help for the success of removing excess skin laxity.
I’m guessing most plastic surgeons would have this figured out but for those who haven’t been in the situation before it may not be immediately obvious.
Have in person consultations with multiple local board-certified plastic surgeons. See what each provider has to say and have a very clear understanding of what they plan to do with your midline scar during the procedure.
Leaving it in tact will hamper the result. Excising the scar and letting it re-heal should not add any increased risk and will give you the best outcome.
Having previously placed mesh may potentially increase risk for bacterial contamination but I don’t think it should prevent you from moving forward if by all other measures you’re a good candidate and want the procedure.
It’s hard to tell from your pictures if you have bulging muscle separation or if muscle tightening is indicated. if it is then the mesh may be a potential challenge.
All things to be discussed during in person consultations with local board-certified plastic surgeons in your community.
Judge plastic surgeons for this procedure based on who gets the most natural looking belly buttons with a very low set scar that follows and the timing contours naturally and even on both sides.
Best,
Mats Hagstrom MD

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