Feasible to Have a Tummy Tuck During Colon Resection Surgery?

Question

35 yr old caucasian female, 5ft, 133lbs, hx of keloid scars, 2 c-sections, Crohns dx otherwise healthy. Thick through abdominal area. Is it possible to have needed colon resection by general surgeon (removing approx 10 inches of combined small & large intestines d/t narrowing) & then close w/ tummy tuck +/- liposuction by plastic surgeon? I want to combine procedures & minimize likelihood of scars. Low transverse is fine, avoid vertical incision scars. What are risks? Is this ever done?

Joseph Mele, MD · Answer

Cosmetic plastic surgery is by its nature "clean" surgery. Tummy tucks and liposuction have low rates of infection, because, other then the skin, there is normally no other source of contamination. Peri-operative antibiotics are chosen to cover the Staph and Strep normally found on the skin, and to further reduce the incidence of infection.

	Colon resection, on the other hand, has two sources of contamination, the skin and the colon. The colon has different bacteria, and requires different antibiotic coverage. Even though the colon is prepped, there is a slightly higher risk of infection with this type of surgery.

	I would recommend separating your hazards. Have the colon resection, be certain that you are going to heal sufficiently from this procedure, and then later have the cosmetic procedures. Your recovery will be easier and the procedures will be safer. By following you colon resection with the cosmetic procedure, the scar can still be revised or removed with the tummy tuck.

	The placement of the initial scar can be coordinated with your surgeon in conjunction with your plastic surgeon for the best cosmetic result. Staging the procedures will provide you with a safer and more predictable result, without compromising the cosmetic outcome.

Earl Stephenson, Jr., MD, DDS, MBA · Answer

Several issues here in my mind:

	(1) The usual approach for your general surgery procedure is a vertical midline (at least when I trained)

	(2) I would not add a low transverse incision to the above incision plus liposuction.  You are only asking to have poor healing problems (ie wounds)

	(3) Your proposed suggestion would prolong a necessary operative procedure

	(4) You were or are on some type of medications to suppress you immune system (steroid) for your inflammatory bowel disease which can lead to poor healing.

	These a just a few reasons.  It is unwise to combine these procedures.  Possibly you may not be the best candidate regardless of timing for body contour surgery.

	Consult with several board certified plastic surgeons.

	Dr. ES

Armando Soto, MD, FACS · Answer

Hi there-

	I agree with the majority of my colleagues who have done a great job explaining why this would not be in your best interests. Please don't do this.

John Philip Connors III, MD · Answer

Great question and we as plastic surgeons get this "type" of question all the time...."Can I have a tummy tuck while another surgeon does a (fill in blank)?"

	See Dr. Kavali's response....I agree, just say no! What is the plan with your small intestine? An osteomy? A Pouch procedure? What is your post-operative medication plan? 

	You body's ability to heal after this type of combined surgery will need to be maximized and I am sure that your colectomy is due to inability to control your Crohn's Disease medically. Steroids, anit-inflammatory meds including antimetabolities has compromised your wound healing capacity significantly.

	Have your general surgeon do his or her thing...recover...maximize your nutrition...build strength and optimize your healing capacity....then go back to your favorite Board Certified Plastic Surgeon and let them plan your surgical strategy with you.

	Stage the new you!

	Hope this helps and good luck!

	Dr. C

Scott Tucker, MD · Answer

Colon resection surgery is often frought with problems such as wound infections.  You would be much better of getting your colon surgery done and the after you recover doing the tummy tuck.  This would just be a safer way to proceed.

	Good luck with your surgery,

	Dr T

Otto Joseph Placik, MD · Answer

While performing tummy tucks with hysterectomy or laparascopic cholecystectomy are relatively common, I am not aware of the combination of tummy tuck and colon resection being performed with any frequency. There is similar controversy with tummy tuck following delivery or c-section.

George John Alexander, MD, FACS · Answer

Some surgeries can be combined, such as a hysterectomy and a tummy tuck or a hernia repair and a tummy tuck. I would not recommend an elective tummy tuck to be done at the same time as a colon resection. You may find a plastic surgeon to do this procedure, but keep in mind by combining these surgeries, you would be at a higher risk for infection.

James Knoetgen, III, MD · Answer

I would strongly advise you against combining bowel surgery (colon, small bowel, stomach, etc) with a tummy tuck. When the general surgeon removes the bowel, the incisions becomes mildly contaminated. This contamination, even though it is mild, will put you at increased risk of infection and wound healing problems. You're much better off having the necessary bowel surgery, allow yourself several months to completely heal and recover, then consult with a board certified plastic surgeon about a tummy tuck. I hope this helps and wish you all the best!

Steven Wallach, MD · Answer

It is probably not a good idea to have a tummy tuck at the same time as a colon resection for crohn's disease.

Shahin Javaheri, MD · Answer

What is the rush?  Wait until you have healed and recovered from the colon resection.  Your risks of infection will be higher and other concerns stated.

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