Muscle repair with mesh? (Photo)

Question

posted in dec, this is follow up. muscle repair came undone, 2x happend. 3x tummy tuck. 1 mini 2 full. confirmed CT 2 finger width apart. happened becus PT (no pain) last yr 4 back surgery in aug. gen surgeon said if i fix, needs mesh. heard bad things about mesh. How eff muscle repair w/mesh? Gen Dr says 50/50 eff? Should fix w/gen Dr? Leave alone? Scared scar tissue/myofacial restrictions. My Dr doesn't do mesh, find another plastics? Idk if i can do another incision. Laparoscopically?

Daniel Barrett, MD · Answer

Dear bigblueyes76,
it is hard to tell for sure without an examination. Generally speaking, most surgeons don't use mesh if they can tighten the muscles together. If you are considering surgery, I would suggest you consult a board-certified plastic surgeon. Only after a thorough examination, you will get more information and recommendations.
Daniel Barrett, MDCertified, American Board of Plastic SurgeryMember, American Society of Plastic SurgeryMember, American Society of Aesthetic Plastic Surgery

J. Timothy Katzen, MD, FACS · Answer

Hello bigblueyes76. Thank you for your question regarding the option of muscle repair with mesh following the failure of previous repairs after your tummy tuck surgeries.

You've certainly been through a lot with three tummy tuck procedures and experiencing the muscle repair coming undone twice. It's understandable to feel concerned about the next steps, especially with conflicting information about the use of mesh.

Effectiveness of Mesh in Muscle Repair: Generally, the use of mesh in muscle repair, particularly after multiple failed attempts, is viewed positively in the plastic surgery community. While your general surgeon mentioned a 50/50 effectiveness, most plastic surgeons find that mesh can provide a strong, supportive repair with a high success rate, often cited around 95% effectiveness. Mesh acts as a scaffold that supports the weakened or separated muscles, allowing tissue to integrate and strengthen the repair over time.

Concerns About Mesh: It’s important to address concerns about mesh, such as potential complications including infection, pain, or reaction to the mesh. These concerns are valid but can often be mitigated by using high-quality materials and ensuring the surgery is performed by an experienced surgeon.

Surgical Options:

Finding a Specialist: Since your current doctor does not use mesh, it would be advisable to consult with another board-certified plastic surgeon who specializes in abdominal reconstructions and is experienced with mesh repairs. They can provide a second opinion and discuss the potential benefits and risks in your specific case.
Laparoscopic Approach: While laparoscopic surgery is less invasive, it may not always be suitable for all types of muscle repairs, especially complex cases where significant support is needed. It's worth discussing this option with a surgeon who performs both open and laparoscopic procedures to understand the best approach for your situation.
Next Steps:

Consultations: Meeting with a few surgeons for consultations can provide you with a range of opinions and treatment plans, helping you make a well-informed decision.
Weighing Risks and Benefits: Consider both the functional benefits of having a stable, repaired abdominal wall versus the risks and potential complications of another surgery.
Your feelings of hesitation about undergoing another procedure are completely understandable. If the muscle separation is not causing functional problems or pain, and if the idea of another surgery is overwhelming, it might be reasonable to hold off on further surgical interventions.

However, if the separation significantly affects your quality of life or physical functionality, exploring the option of repair with mesh might be worthwhile.

I hope this answer helps clarify your options and provides guidance on how to proceed with addressing your muscle repair concerns. Good luck as you consider your next steps.

Sincerely,

J. Timothy Katzen, MD, FASMBS, FICS
Plastic Surgeon

Gerald Minniti, MD, FACS · Answer

Thanks to our system of law, issues can be gamed to produce winning results for plaintiff attorneys. There is perhaps no better example than claimed injuries from drugs or medical devices. Starting in the late 1990s and early 2000s, polypropylene mesh (permanent material) used by general surgeons to plug hernias became the darling for said attorneys to create a 'thing' about them. This was broadcasted to the world via TV/internet/social media commercials and news stories. What's important for you to know is that issues were specific to how the mesh was used, not the mesh itself. Most plastic surgeons who use mesh use a resorbable kind anyway. I rather confused about your issues with rectus plication, but if someone wants to use mesh after re-plication of the rectus muscles, it won't hurt you.

Connie Hiers, MD, FACS · Answer

First, please write in complete sentences so we can better understand specifically what you are asking. Second, go for an examination with another plastic surgeon. You might need mesh if the repair has failed twice.

Arif Eroglu, MD · Answer

Hello; In recurrent rectus diastasis, despite the presence of CT findings; when leaving off from bed, in that area; such as bulginess; if there is no visible problem; there is no need for doing anything. But, if there is a visible problem; how the repair was done; we need to look and check. If the proper muscle repair has been done; with mesh; repair may be considered. If the proper repair has not been made; muscle plication must be performed; in accordance with the procedure. Mesh; if necessary, it can be entered through this Tummy Tuck incision; it can also be done laparoscopically.

Muscle repair with mesh? (Photo)

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Muscle repair with mesh? (Photo)

Answers (5)

Answer: Revision

Answer: Revision

Answer: Detailed Analyzes

Answer: Detailed Analyzes

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Everything you need to know about Tummy Tuck Revision

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