Tummy tuck after emergency gallbladder removal?

Question

I had emergency gallbladder removal 12 years ago as it started to attack other organs so I am left with a large 12 inch scar across my abdomen. I’m looking into getting a tummy tuck and advise to have an extended tummy tuck. Will this be risky or ok to proceed

J. Timothy Katzen, MD, FACS · Answer

Thank you for your question regarding a tummy tuck after having an emergency gallbladder removal. Given that you have a 12-inch scar across your abdomen, this can affect the approach to your tummy tuck surgery, but it’s still possible to achieve excellent results with the right surgical plan.

Risks and Considerations:
When there is a significant scar across the abdomen, like yours from gallbladder removal, it’s essential to consider how the scar has impacted the blood supply in the area. Scars can disrupt the natural blood flow to the tissues, and this needs to be taken into account during surgery to avoid complications. To protect the blood supply, your surgeon may need to take an unconventional approach when performing the tummy tuck. This could involve modifying the incision or adjusting the extent of tissue removal to ensure proper healing and minimize the risk of complications such as delayed wound healing or tissue loss.

Extended Tummy Tuck Possibility:
An extended tummy tuck, which addresses the flanks and lower abdomen, can still be an option. Your surgeon may be able to incorporate your existing scar into the new incision line, reducing the overall scarring. However, careful planning will be necessary to work around the scar tissue to maintain healthy blood flow to the skin and tissues.

Case Example - Liver Donor Scar:
In cases like yours, we have successfully performed tummy tucks on patients with large scars. For example, we recently operated on a patient with a liver donor scar, which posed similar challenges due to disrupted blood supply. By carefully planning the procedure, we were able to achieve a smooth and natural result while protecting the healing process. Please refer to the video below to see how we handled a similar situation with a liver donor scar.

It’s crucial to consult with a board-certified plastic surgeon experienced in managing cases with significant scarring. They will assess your situation and develop a customized surgical plan to ensure the best results while minimizing risks.

Sincerely,
Dr. Katzen

Wayne I. Yamahata, MD · Answer

The prior surgery will place you at greater risk for problems with healing as well as the potential for tissue necrosis. As the surgery was done 12 years ago, the risks are not a great as a more recent procedure. There are techniques and procedures that can mitigate these risks. Most experienced board-certified plastic surgeons would feel comfortable performing the procedure using these mitigating maneuvers.

Gary M. Horndeski, MD · Answer

You have not described where the scar is or provided photographs. However, if the scar is in the right upper quadrant of the abdomen then this can interfere with the blood supply to the lower right quadrant of the abdomen and lead to complications. If the gall bladder was removed through a midline incision then it would not be risky.

Best Wishes,

Gary Horndeski, M.D.

Best Wishes,

Gary Horndeski, M.D.

Carmina Cardenas, MD · Answer

The problem after a gallbladder open procedure is the high risk of ending with skin necrosis after a regular TT, below the  colecistectomy incision, specially because your scar seems to be very large. 
Limited undermining will be key to prevent that. 
Your surgeon must have a lot of experience in TT in order to have a safe procedure. 
Be encouraged!
Dr. Cardenas

Camille Cash, MD · Answer

Having a previous large abdominal scar increases your risk of complications.  Blood supply could be compromised leading to poor healing of the tummy tuck or even necrosis. I encourage you to meet with a board certified plastic surgeon near you who can determine if you are a candidate after an exam.

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