Is a full tummy tuck possible after open gallbladder surgery? (Photo)

Question

Hi, I am a 34 year old mother of 5 children.I had my last child 2 years ago,via c-section.My gallbladder was removed 5 months after child birth.I have been disgusted with this apple shaped midsection. I recently had a consultation with a plastic surgeon and he recommends a mini tummy tuck. I see how it can benefit a thinner person with less loose skin but not sure how it can benefit me.I want to choose the safest method with maximum noticable results.Will I have a belly button afterwards?

Sam Jejurikar, MD · Answer

Greetings,At present, you are not a great candidate for either mini or full tummy tuck. Your "apple shaped midsection" is mainly the result of excess intra-abdominal fat; the best way to help this is with weight loss. With that, the ability to get a flat abdominoplasty will be more feasible with a tummy tuck. Although you will still have an increased risk for post-op wound healing complications because of the open gallbladder scar, the risk will be diminished with preoperative weight loss.Hope this helps - Sam Jejurikar, MD

S. Larry Schlesinger, MD, FACS · Answer

Thank you for this excellent question.  As I am sure your plastic surgeon told you during your consultation, the gall bladder incision severed the superior epigastric blood vessels.  Because of this large scar, any attempt at a full tummy tuck would leave you with a great chance of having necrosis of the tissue on the right side of your abdomen.  Therefore, if you were my patient, I would recommend a more indirect approach.Firstly, since you do have some fat on the upper and lower portions of your abdomen, I would do an aggressive liposuction which will change the blood supply to the skin from vertical to horizontal.  That is, the blood supply to the skin of the abdomen comes through muscles vertically up to the skin.  After liposuction, there is a shift in the origin of the blood supply to horizontal.  What all this means is that after an aggressive liposuction, your skin would have a better chance of tolerating a full tummy tuck.Next, I would allow at least six months after the liposuction to do the tummy tuck and I would consider hyperbaric oxygen therapy, both before and after the tummy tuck to ensure good oxygenation to help heal the abdominoplasty incision.  Finally, I am a big fan of DMSO.  This wood product opens choke vessels everywhere in the body.  Choke vessels are a redundant blood supply which opens up under low oxygen tension.  This extra blood supply plus the added oxygen from the hyperbaric chamber should allow you to heal with minimal complications.  In my opinion, this is the safest method with maximum notable results.  Having a belly button potentially increases the risk to the vascularity of the lower portion of your abdomen, but I think a few extra hyperbaric treatments should compensate for any lost vascularity from the creation of your new belly button.

Gary Lawton, MD, FACS · Answer

Based on the location and size of this scar and the size of your abdomen, you are not a good candidate for a tummy tuck. A mini tummy tuck will do nothing for you  to achieve your goals.

Kenneth Hughes, MD · Answer

Tummy tuck can be performed after an open gallbladder surgery.  I
would search for the board certified plastic surgeon who you feel is
most likely to give you the best results and who performs hundreds of
these procedures each year. I would look at patient reviews as well as
before and after photos on that surgeon's website.Kenneth Hughes, MDLos Angeles, CA

Austin Hayes, MD · Answer

It's a great question and the answer is yes. However, it's important to understand that after gallbladder surgery the blood supply to the skin can be changed by the incision from the gallbladder excision. This can put some of the skin at increased risk. A fleur-de-lis abdominoplasty uses a second vertical incision to remove excess skin. In some situations the gallbladder scar can be removed with the vertical abdominoplasty incision.Given your photos it seems that you're currently not a good candidate for an abdominoplasty procedure. It appears that a significant amount of your weight is carried within your abdomen. This is not treated with a tummy tuck procedure, and in fact makes the surgery more difficult. I would recommend checking your body mass index (BMI) and making sure that it is less than 30. This decreases the risks of complications after the procedure. Also it's important to make sure that you have reached a long-term stable weight. This gives the best chance of having a long lasting result.

Curtis Wong, MD · Answer

can safely be done but your photo shows someone who will benefit minimally from any cosmetic procedure.  When you lay flat on your back, what does your tummy look like?  If its okay to you, and you're maintaining your weight where its not fluctuating, you could benefit from procedures.  But at your current condition, you're at increased risks for complications such as infection and wound issues.  If your tummy protrudes when on your back, it indicates excessive fat inside your abdominal wall and you must lose weight before you can have any appreciable benefit.  As for your belly button, if you're not in love with it, many of my patients will give it up and have a belly button reconstructed later in the office.

Jaime Campos Leon, MD · Answer

Hi, thanks for posting your picture and for your inquiry. A tummy tuck could be performed after an open gallbladder surgery, the thing is that if you are really looking for optimal results you would need to be closer to your ideal weight as much as possible. Please have an in person or a virtual (Skype) consultation so you can discuss your concerns, options and expectations thoroughly. Good luck in your PS Journey!Respectfully,Dr. Jaime Campos-Leon

Khashayar Mohebali, MD, FACS · Answer

In general you are much more higher risk for bloody supply and healing issues given your open surgery.  However there are situations when it might be possible.  Get evaluated by a surgeon to get the full answer.

Ron Hazani, MD, FACS · Answer

A TT after gall bladder surgery is possible. I recommend weight loss, lifestyle changes including exercise, and staging the procedure to reduce the chance for wound healing complications.

S. Daniel Golshani, MD, FACS · Answer

This is an excellent question. YES IT IS possible to have a full tummy tuck after having had an open cholecystectomy. However, the correct technique must be carefully used to avoid skin ischemia and necrosis both of which are bad complications which need to be avoided. From the photo I agree that you would benefit most from a full abdominoplasty. Make sure to consult with a board certified plastic surgeon ( American Board of Plastic Surgery) regarding techniques that can be used to minimize risks and improve outcome in your case. A tummy tuck can be a freeing and life empowering procedure. Best, Daniel Golshani, M.D., Beverly Hills.

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