I have an umbilical hernia/diastasis/atrophy. Will a mini tummy tuck fix my belly? Scared of the scar and recovery. (photo)

Question

Will doctors be able to use my csec scar, I don’t want to have two scars and end up looking like Frankenstein. I have 2 small kids that I still carry around, how long is the recovery and how painful? I’m allergic to nsaids so all the good painkillers/anti inflammatory drugs are unavailable to me.

Kenneth Hughes, MD · Answer

A short scar TT (The shorter scar it leaves is the same length as that of the mini TT) tightens the muscles, and removes skin and fat. The incision is so low that bikinis may be worn afterwards. It creates a scar which is flat all the way across and is not a smiley face. This way the ends of the scar never rise above low cut clothing. The umbilical hernia can be repaired at the same time.
  
Generally, patients require only one or two weeks to recover. Patients are advised not to perform strenuous exercises for four to six weeks after the surgery.  Most PSs would recommend that you wait at least 6 weeks before lifting greater than 10 lbs.Pain control is important.  I typically use whatever medication a patient has used in the past that has had success.  If the patient has never had surgery or never used pain medication, I use oral narcotic meds of varying strengths.   I think that many patients require prescription pain medications for the first week or so with the transition to the use of Tylenol for the next week.

Richard Baxter, MD · Answer

A mini tummy tuck can be done with complete repair of the muscle separation and the umbilical hernia using the umbilical float technique. Your existing C-section scar would be used, perhaps extended a  bit. there would not be much skin removal possible so minimal effect on stretch marks.

Daniel Barrett, MD · Answer

Dear DRDR2020,
based on your photos, you look like a good candidate for a TT. Full tummy tuck should tighten your abdominal muscles and remove the excess skin. I would suggest you to consult a board-certified plastic surgeon because 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

Nelson Castillo, MD · Answer

Thank you for sharing your question and photographs.  It appears that you have muscle and skin laxity present above and below the bellow button.  In most cases this requires a full tummy tuck to fully address, but this relies on an in-person examination to assess the degree of excess tissue present.  At times with limited tissue a mini-TT and an incision into the belly button can be used to avoid a full tummy tuck.  See a specialist in consultation to discuss the specifics.

Pejman Aflaki, MD · Answer

Hello and thank you for your question. Only an in-person consultation and physical examination would be able to give you a more definitive answer. The degree of skin laxity in you abdominal wall can only be established by a physical examination. I think you will probably have a much better result with a full tummy tuck. A mini tummy tuck does not include a full-length muscle repair. During tummy tuck, extra skin in the lower half of your abdomen including the stretch marks will be removed. In addition, typically the fascial laxity/separation of recti muscles will be taken care of by muscle plication, giving you a flat abdomen. The added liposuction of your hips/flanks will help with creating a natural and aesthetic waistline. Incision can be placed very low to be hidden under bikini. With proper surgical technique, belly button can be designed to  be a true 'innie'. Recovery from tummy tuck is 1-2 weeks. Strenuous activity and lifting heavy weights should be avoided 6 weeks to 3 months post op. I would seek consultation with a board-certified plastic surgeon for a full evaluation and advice. Best,
  
Pejman Aflaki, M.D.                                            
  
Johns Hopkins-trained double board-certified plastic surgeon

Dallas Buchanan, MD · Answer

Thank you for your pictures and questions. I would suggest a consultation with a plastic surgeon who is board certified by the American Board of Plastic Surgery. It takes a detailed discussion to decide what procedure is appropriate for patients such as yourself. The short answer is that if you are completely satisfied with everything about your abdomen above your belly button, then a mini might be an option for you.Hope this helps!Dallas R. Buchanan, MD, FACSOwner & Board-Certified Plastic SurgeonVIVIFY plastic surgery

Camille Cash, MD · Answer

From your photos you are a better candidate for a standard tummy tuck.  Your c-section scar will be removed as part of the procedure and replaced by a new scar.  I encourage you to begin by visiting with a board certified plastic surgeon near you for a consultation.  Here you will learn more about the procedure, the results, and what you can expect from recovery.

Connie Hiers, MD, FACS · Answer

The hernia repair will need its own incision. The mini tuck will use a new incision just below your C section scar to remove the old scar as excess skin is removed.  You will won't be able to carry your children for a while to let things heal. Or, you can wait until you no longer have to carry children.

Arian Mowlavi, MD, FACS (license on probation) · Answer

You would benefit from a tummy tuck. This would remove excess skin and fat, while at the same time tightening the abdominal muscle. The umbilical hernia can be resolved at the same time. The incision is place below the bikini line to reduce visibility. Patients often return to normal activity four weeks after the procedure, but can resume light activity 1-2 weeks following the procedure. A Skype or FaceTime consultation with a tummy tuck specialist will help you get an accurate recommendation and pricing.
Respectfully, 
Arian Mowlavi MD, FACS
Realself 100 Hall of Fame Inductee

Mats Hagstrom, MD (license on probation) · Answer

The decision of what procedure to choose should be Based on an accurate assessment that diagnosis the underlying problem. Pregnancy related changes come down to muscle separation and skin laxity. These are both appropriately treated through a full tummy tuck. A mini tummy tuck generally treats skin laxity below the belly button only. You can do muscle tightening with a mini tummy tuck but only below the belly button. This often causes the upper abdomen to bulge more as the lower abdomen gets pulled tight.A mini tummy tuck is appropriate for patients who have skin laxity below the belly button as you’re only problem.If you want to have a flat abdomen you will need muscle tightening which should be done on the upper and lower abdomen.Any type of tummy tuck should include removing your C-section scar and leave you with only one scar.You could do a skin only mini tummy tuck but it will only address skin.The recovery from tummy tucks is related to muscle tightening. If no muscle tightening is done and the recovery is very easy. Like an office-based procedure. With muscle tightening this becomes one of the most invasive procedures you can have.Generally far worse than recovering from a C-section.In the end the decision should be made on what the underlying problem is, what you’re trying to achieve and what you’re willing to go through. These variables together determine the best appropriate procedure for each individual person.That’s very different than recommending what will give the most impressive results for every person. some people don’t want the best result they just want a small improvement.Others can’t justify having surgery unless they get the best possible outcome with major changes.Of course everybody wants the least invasive procedure with the least number of drawbacks to get the best results.The best scenario starts by understanding the problem and accepting  that treatments that don’t address the primary problem will give limited results.A full tummy tuck is generally not appropriate for someone who may consider having more children in the future.I suggest having a few in person consultations with local board-certified plastic surgeons who have years of experience. Look for surgeons who have consistently good reviews, excellent before and after pictures and seem to listen to your needs and desires as well as concerns.You’ll find that some plastic surgeons are more dogmatic than others.Summer dictates the choice of operation completely while others leave the decision completely up to the patientSome healthy balance in between is probably best.Best, Mats Hagstrom MD

I have an umbilical hernia/diastasis/atrophy. Will a mini tummy tuck fix my belly? Scared of the scar and recovery. (photo)

Answers (12)

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