1. Do bellies permanently pooch after a hysterectomy? 2. Is TT recovery harder or the same as a hysterectomy?

Question

I had a hysterectomy 3 years ago. IMMEDIATELY after the surgery my lower abs have a PERMANENT pooch. What caused this?

Gary M. Horndeski, MD · Answer

Unfortunately, you have not provided photographs but it is possible that your abdominal wall was injured at the time of hysterectomy.  If this is the situation then you would need to reinforce the mechanical strength of the abdominal wall and mesh is required.  The technique I recommend is abdominoplasty with mesh reinforcement, if you are not planning future pregnancies.  The mesh creates a more hourglass figure by compressing the abdominal wall resulting in early satiety and helps maintain a reduced weight.  Tummy tucks do hurt more than hysterectomies.Best Wishes,Gary Horndeski, M.D.

Thomas A. Mustoe, MD, FACS · Answer

You probably had some skin laxity which is typical after pregnancy especially and with the scar contraction which is typical as part of healing the skin above formed an over hang.  This is common after Caesarean sections as well.  Recovery after TT varies with surgeons but in my hands with attention to several factors most return to work in one week.  Because the dissection is superficial to the abdominal muscles and they are not cut in a TT the recovery is significantly faster than hysterectomy.

Kenneth Hughes, MD · Answer

Hello. Great question. With out images and a personal examination is difficult to provide a proper assessment of your pooch.

Nelson Castillo, MD · Answer

Thank you for sharing your question. Unfortunately without an in-person examination, or full series of photographs, it is difficult to comment what may be the source of your “pooch.”  Most often this is loose skin that was exacerbated after the hysterectomy and can be treated with a tummy tuck procedure.  Most patients feel their hysterectomy was more painful than a full tummy tuck.  Hope this helps.

Matthew A. DelMauro, MD, FACS · Answer

Hello! Thank you for your question. (Keep in mind that an in-person consultation is necessary for the best advice.) After any surgery that goes through the abdominal wall (e.g., hysterectomy) there is some weakness of the abdominal wall---leading to a "pooch". Hopefully, as you heal that "pooch" will go away. If it doesn't, a tummy tuck may be an option. 
Recovery from a tummy tuck is not harder or easier than recovery from a hysterectomy. It is only different. Although postoperative protocols vary by plastic surgeon, patients are usually able to resume unrestricted activities (including abdominal strengthening exercises) by 6 weeks after surgery.
If you decide to pursue surgery it’s very important that you find a surgeon whom you are comfortable with and trust and who evaluates you in-person and tailors an individualized treatment plan for you and your aesthetic goals. Best of luck!
Matthew A. DelMauro, M.D.

John Rosdeutscher, MD · Answer

That bulge is most likely caused by some muscle weakness (likely combination of previous pregnancy & surgery). It can usually be repaired/reinforced during abdominoplasty. Abdominoplasty is different than hysterectomy recovery, but probably somewhat similar time frame. Nothing substitutes for an in-person consultation & exam with a qualified board-certified Plastic Surgeon. Best of luck!

Amaka Nwubah, MD · Answer

Bellies generally pooch most commonly after pregnancy due to separation of the midline muscles - this is known as rectus diastasis. After a hysterectomy, your bulging could be due to abdominal wall muscle weakness after surgery for various reasons, but difficult to know without pictures. Tummy tuck surgery addresses excess skin over the abdomen as well as any midline muscle weakness you might have. The recovery is generally 2-3 weeks. In comparison to a hysterectomy, since there is no manipulation of the actual organs, and it is primarily skin repositioning it might be a little less than a hysterectomy. However, the midline muscles are tightening which really is what prolongs the recovery more than anything. Overall, the recovery might be slightly less to similar to a hysterectomy, but it ultimately is person dependent.

Camille Cash, MD · Answer

It is difficult to comment on what occurred during your hysterectomy to cause the excess in your abdomen.  The good news is that a tummy tuck addresses the abdomen by removing excess fat and skin and repairing abdominal wall laxity.  See a board certified plastic surgeon in your area for a consultation to learn more.

Stephen M. Davis, MD, FACS · Answer

Thanks for writing,Typically during a hysterectomy the skin is lifted, the muscle are separated in the mid-line, the surgeon does the operation then the muscles are put them back together. Therefore the fullness / pooch is excess skin with poor elasticity and tone. Sometimes with time this shrinks but usually not. Relative to recovery, almost all of my patients will tell you this is an easier operation post-op then a hysterectomy. An important point here is the concept of scar strength. Scar takes 6 weeks to maximize it’s strength, it makes no difference what operation it is. As a general rule at 10 days post-op there is 10% wound strength, the sutures are doing all the work. So you may be more comfortable but you still need to exercise restraint because time and wound healing are your friend, no one can make you heal any faster.  With an abdominoplasty the muscle typically are further tightened in the mid-line with sutures and again time is your friend. I hope this helpsStephen M. Davis, MD, FACSCertified: American Board of Plastic SurgeryMember: American Society for Aesthetics Plastic SurgeryMember: American Society of Plastic SurgeonsMember:RealSelf Hall of Fame

Michael K. Obeng, MD, FACS (license on probation) · Answer

Hello and thank you for the question. The bulge in your stomach is most likely caused by muscle weakness. Tummy Tuck is different than hysterectomy recovery, recovery time may vary based on your body. Before you have any surgery, my recommendation is to try to eat healthy, incorporate more protein in your diet to aid your healing. Try as much as possible to get to your ideal body weight or a healthy weight. And also please make sure that your surgeon is board-certified by the American Board of Plastic Surgery, and he or she has hospital privileges to do the same type of procedure(s) in the hospital that he or she plans to do on you, and finally an accredited surgery center is used. Thank you and best of luck!

1. Do bellies permanently pooch after a hysterectomy? 2. Is TT recovery harder or the same as a hysterectomy?

Answers (10)

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