Had a torn bladder during a caesarean section. Could I safely have a tummy tuck four years later?

Question

Could this be a problem? Do they go near your bladder and will there be scaring around the area ?

Harry T. Haramis, MD, FACS · Answer

As long as bladder has fully healed, which should be after years, this should pose no problem to a safe tummy tuck.

Robert M. Lowen, MD · Answer

Dear Humorous,
 Yes, a tummy tuck is frequently done on patients with a previous C section.  The C section scar is carefully separated from the abdominal wall by dissecting  from unscarred areas above and lateral to
the scar and isolating the scar.  The scar is then freed from the abdominal wall and the bladder is not going to get injured.
  The case linked shows a tummy tuck done on a patient with extensive lower abdominal scarring, all of which had to be carefully separated from the abdominal wall without injuring the muscle fascia.

Semih Yildiz, MD, FEBOPRAS · Answer

A prior bladder injury does not automatically rule out a tummy tuck, but it is important information for the surgeon. A tummy tuck is usually performed in the skin/fat layer over the abdominal wall, and the bladder is deeper in the pelvis, so it is not normally the main surgical area.
That said, prior C-sections and a bladder repair can create scar tissue in the lower abdomen. I would bring all operative records if available and make sure your plastic surgeon knows exactly what happened. In some cases, coordination with your OB/GYN or urologist is helpful before surgery.

Daniel Barrett, MD · Answer

Dear Humorous431195,

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

Leila Kasrai, MD, FRCSC · Answer

Torn bladder repair surgery should not interfere with your ability to get a tummy tuck, as long as you have healed and have no further issues.

Sameer Karkhanis, MS, DNB · Answer

Hello! During Tummy tuck surgery we are always above the muscles of abdominal wall. In no way, we entre the abdominal cavity during this. You can safely undergo tummy tuck surgery following your previous surgery. However, we routinely advise the patients to do ultrasonography examination of abdomen, if the person has undergone surgery previously, just be precautious and safe during surgery.
We routinely do mommy-makeover surgeries at our Centre for Cosmetic Surgery, Mumbai, India.
Thank  you,

Regards,
Dr Sameer Karkhanis,
Centre for Cosmetic Surgery, Mumbai, India

Jeffrey M. Darrow, MD · Answer

A tummy tuck includes removal of the excess skin of the abdomen and, in some patients, a suture repair of the separation of the rectus muscles to create the flattest abdomen possible.  The bladder is deep to all these tissues and would not be affected during an abdominoplasty/tummy tuck.  Best wishes.

Emre Guvercin, MD, FEBOPRAS · Answer

In most cases, yes, you can safely have a tummy tuck four years after a bladder injury during a cesarean section, provided you healed properly and have no ongoing urinary complications. A standard abdominoplasty is performed in the abdominal wall layer above the muscle and does not directly operate on or enter the pelvic cavity where the bladder sits. The surgeon works in the plane between the skin/fat and the abdominal fascia, so they are not dissecting near the bladder itself. However, prior C-section scarring &mdash; especially if there was a complication like a bladder injury &mdash; can create internal scar tissue (adhesions). While this usually does not prevent surgery, it is important that your plastic surgeon is aware of the history so they can plan carefully. If you have no current bladder symptoms, infections, pain, or urinary issues, a prior repaired bladder injury alone is not typically a contraindication to abdominoplasty. A preoperative consultation and possibly review of operative records would provide additional reassurance.

Jacob Carlson, MD · Answer

In a tummy tuck, the dissection proceeds through the skin and fatty tissue down to the level of the abdominal wall musculature. The dissection does NOT go deeper than the abdominal wall fascia. The bladder is a intra-peritoneal organ, so there should not be any concern for injury to the bladder. There will definitely be scar tissue extending from the level of the skin down through the fat to the abdominal wall. And most of that scar tissue will be removed during a tummy tuck. But to ensure that there are no surprises during surgery, your surgeon should perform a physical exam and/or obtaining imaging to ensure that are no abdominal wall defects or hernias present which would need to be addressed before/during your tummy tuck.

Paul M. Parker, MD, FACS · Answer

Assuming that you are not having any problems after your torn bladder repair, having a tummy tuck now should not be affected by that. A tummy tuck procedure is in the superficial abdomen including the muscle repair and does not go near the bladder. Good luck!

Had a torn bladder during a caesarean section. Could I safely have a tummy tuck four years later?

Answers (13)

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