Should I Have a Revision for Failed Muscle Repair?

4.2 petite lady had a full muscle repair 6 months ago all went well but had constipation issues.However the upper abdomen is distended.Surgeon feels the repair failed not due to lax muscles though.Is it worth redoing procedure with mesh and what kinds of risks are now associated with scar tissue and mesh now.I am very short and small with thin skin otherwise healthy and well.And would the operation still fail with mesh.

Doctor Answers 6

Revision tummy tuck works.


I doubt your problems have anything to do with constipation.  I recommend getting two other opinions.

Manhattan Plastic Surgeon
4.8 out of 5 stars 9 reviews

Should I have a revision for failed muscle repair?

I would suggest going ahead with the surgery. Mesh should reinforce the anterior abdominal wall and lead to a flat abdomen. There should not be too much scar tissue from your prior abdominoplasty. Sometimes when the muscle is lax, the only way to flatten the abdomen is by using mesh. I believe the benefits would outweigh the risks. Good luck with your reconstructive plastic surgery. Sincerely, Dr. Katzen

J. Timothy Katzen, MD, FACS
Los Angeles Plastic Surgeon
5.0 out of 5 stars 194 reviews

Bulge after Tummy Tuck

It is very unusual to need mesh for an abdominoplasty.  A picture would be helpful. Sometimes there can be some fullness above the belly button.  If you truly have that much laxity of your abdominal wall then mesh may be an option or a biologic matrix such as STRATTICE®.

Dr. ES

Mesh for Failed Plication

    If the plication failed and the surgeon thought the fascia was weak at the time of repair, then mesh overlay with plication makes sense.  There are many types of mesh, which the surgeon should be able to select.  If the surgeon does not use mesh, a general surgeon can be consulted.  There is always a risk of recurrence.  Mesh can always get infected.  Some surgeons use a dermal matrix overlay.  However, these items are much more expensive, and may be prohibitively so for a cosmetic case.  You should discuss all of these items with your surgeon.

Kenneth B. Hughes, MD
Los Angeles Plastic Surgeon
4.9 out of 5 stars 492 reviews

Revision Tummy Tuck

There is nothing wrong with seeking a second opinion.  If mesh is used, it is best to use a surgeon that is very experienced with it.

Robert E. Zaworski, MD
Atlanta Plastic Surgeon
4.9 out of 5 stars 60 reviews

Should I Have a Revision for Failed Muscle Repair?

I would want to be certain that you surgeon is experienced with mesh--many plastic surgeons do not use mesh often. If there is persistent laxity, mesh is more likely to  maintain a repair as compared with simply redoing what failed last time. 

In terms of minimizing the need for narcotics, the main cause of postop constipation, talk to your surgeon about either injections of Exparel,or the use of pain pumps, both of which will deliver about 3 days worth of local anesthetic to the surgical area.

Thank you for your question, best wishes.

Jourdan Gottlieb, MD
Seattle Plastic Surgeon
4.6 out of 5 stars 45 reviews

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