Can an abdominoplasty be performed and help correct a 4cm midline dehiscence of the abdominal wall?

I have lost 80lbs and currently weigh 275 lbs with a large skirt of fat around my stomach. Eventually I want to have an abdominoplasty performed but right now I have a 4cm midline dehiscence of the abdominal wall. I saw a general surgeon who told me he didn't want to go in and adjust the muscles to try and close the gap. Would I be better off waiting and having an abdominoplasty performed when my weight goes lower? If so, what weight would a 5ft 8in person be okay to have an abdominoplasty at?

Doctor Answers 10

Abdominoplasty after weight loss. Some advices:

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Thank you very much for this interesting and important question. Congratulations on your weight loss.

Try to lose weight before a surgical procedure its a very delicate matter, since in many cases a restrictive diet can cause problems, such as anemia, electrolyte disturbances, decreased protein, etc ... retarding the healing process and damaging the surgery.
For these reasons, if your purpose is to lose weight, i recommend you have a BMI less than or equal to 30.
In this regard, you must to have a support with a nutritionist, so you can achieve the desired goal, in the most healthy way, without incressing complications risks in the plastic surgery to perform.
On the other hand, I recommend you yo be treated by a board certified plastic surgeon, with special training in Plastic Surgery After Massive Weight Loss. Therefore, it will use different surgical techniques and special safety measures for ex- obese patients.
It's very important to make a preparation weeks or even months before the surgery, advising the patient to take certain measures that helps to have a successful surgery with very good results.
You only can perform multiple procedures at the same time if the blood work and pre-op cardiovascular evaluation are in optimal range that allows us to make a safe procedure.

Dr. Emmanuel Mallol.-

Dominican Republic Plastic Surgeon
4.7 out of 5 stars 366 reviews

How much weight loss

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I think as long as you are losing weight I would postpone your surgery and have the hernia correction and the tummy tuck at the same time.It would be great if you could get under 200.

Robert Brueck, MD
Fort Myers Plastic Surgeon
4.9 out of 5 stars 69 reviews

Can an abdominoplasty be performed and help correct a 4cm midline dehiscence of the abdominal wall?

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I agree with the GS opinion, lose more weight. Like another 80 pounds++. Than have a surgical team of a GS and PS operate... 

Diastasis or hernia?

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By your description I am not sure if you have a true hernia or a diastasis( weakening).  It would likely be best to lose weight to get to your goal weight.  Best of luck.

Steven Wallach, MD
New York Plastic Surgeon
4.2 out of 5 stars 30 reviews

Wait until more weight is off..

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The goal would be a BMI from 28-30. A weight of 170 lbs. a large opening is less dangerous than a small separation for complications related to bowel. Wait and it will be worth it.

Peter J. Capizzi, MD
Charlotte Plastic Surgeon
4.9 out of 5 stars 93 reviews

It would be better to wait.

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Hi, mizzmali09.  Congratulations on your weight loss.  Abdominoplasty is a great procedure to get rid of "large skirt of fat" and to tighten the core muscle.  The objective of abdominoplasty is to give you a great abdominal contour.  However, the result of abdominoplasty will be better when you reach your stable, goal weight.  In addition, being obese does increase surgical complication rate.  If you can, try to get your BMI less than 30-35.  Visit with a board-certified plastic surgeon to learn about the benefits, limitations, and potential risks of the procedure.  Best wishes!

Can an abdominoplasty be performed and help correct a 4cm midline dehiscence of the abdominal wall?

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Congratulations on your significant weight loss.  In answer to your question I feel it best to continue with your weight loss regimen until you've reached a stable weight or your goal weight before being examined for a possible tummy tuck.  I don't believe in setting a specific weight for a person to hit before the evaluation, it will be different for each patient.  The more weight you lose the better the contouring results will be and a better chance of repairing your dehiscence.   These surgeries go well together.   I hope you have continued success with your weight loss.

Can an abdominoplasty be performed and help correct a 4cm midline dehiscence of the abdominal wall?

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 Congratulations on your successful weight loss.  Generally speaking, it is always best to achieve long-term stable weight prior to proceeding with body contouring surgery. Doing so, will increase the safety of the operation, will likely improve the outcome of the operation, and will decrease chances that additional surgery will become necessary subsequently.

In my practice, I do not ask specific patients to achieve a specific weight prior to proceeding with tummy tuck surgery. I simply ask patients to achieve a long-term stable weight where he/she feels comfortable and does not expect significant fluctuation postoperatively. As you know, recruiting other professionals such as personal trainers, nutritionists, physicians who specialize in weight loss concerns etc. may be helpful to you.

When the time is right, seeking consultation with well experienced board-certified plastic surgeons will be your next/best step. It will be important to educate yourself about the potential risks/complications associated with surgery and have a good idea of realistic expectations. Keep in mind, that it is a major operation, associated with a significant physical (and often emotional) recovery period. Having enough help/support at home for yourself and any dependents will be an important part of the planning process.
Best wishes.

Can abdominoplasty be performed to correct a 4 cm midline dehiscence?

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First, congratulations on your weight loss!  Yes, you abdominal dehiscence (hernia) repair could be done at the same time as a tummy tuck.  Many plastic surgeons are also general surgery trained and could do both surgeries for you at the same time or your plastic surgeon may feel more comfortable having a general surgeon involved and coordinate your surgery between the two surgeons.  I would recommend losing more weight to have the best chance for good healing and least chance for the hernia returning.  If you google "BMI scales" this can help you to plan for a goal weight.  Ideally your BMI should be under 35 at the least and more ideally under 30.  Best of luck!

Jeffrey A. Sweat, MD
Sacramento Plastic Surgeon
4.9 out of 5 stars 51 reviews

Can an abdominoplasty be performed and help correct a 4cm midline dehiscence of the abdominal wall?

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Thank you for your excellent question.  I agree with your initial assessment that it would be best to wait on having any surgery until you lose weight.  The reason for this is twofold.  By losing the weight you will optimize your aesthetic outcomes as it will allow for a greater removal of excess skin and tissue, while also allow a better contouring of your stomach muscles.  Secondly, by losing weight you will decrease the likelihood of a recurrence of your abdominal wall dehiscence.  Whether the dehiscence is a rectus diastasis (muscle separation) or a hernia (loss of abdominal domain), recurrence is logarhythmically related to weight.  Though ideal weight should be one that you feel comfortable at, and can maintain long term, if you indeed have a hernia, I would recommend getting as close to 200lbs as possible.  The more weight you lose, the lower the risk of any complications from surgery that may occur.  Hope this helps.  

Nelson Castillo, MD
Atlanta Plastic Surgeon
5.0 out of 5 stars 80 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.