Tummy tuck with muscle repair and lipo to the flanks years after an open donor nephrectomy

While it is possible for you to have an abdominoplasty, the extent of the undermining of your skin must be modified/reduced to maintain a blood supply to the skin which is directly beneath your nephrectomy scar, Normally, the abdominal skin gets blood supply from directly beneath it through your sit up muscles and from the surrounding skin. When the skin of the abdomen is raised for a tummy tuck, all of the blood supply from directly beneath it is lost and it survives on blood flow from above your ribs and from around your back, to keep the lower and central part of the abdominal skin alive. Your nephrectomy scar acts like a roadblock to the blood flow through your skin so it can’t get from your upper abdomen to your lower abdomen. Modifying or minimizing elevation of your abdominal skin, so that some of your skin below your scar is left attached to the rectus muscles may allow you to have your tummy tuck. Have a detailed consultation with your plastic surgeon to have these options explained. Best wishes.

Thank you for your question and congratulations on your kidney donation and maintaining great health! Based on your description, it is possible to undergo a tummy tuck with muscle repair and liposuction to the flanks even years after an open donor nephrectomy. However, there are important considerations to discuss with your plastic surgeon.

Your abdominal scar from the nephrectomy running parallel to your rib cage will not inherently prevent you from having a tummy tuck. In fact, surgeons are accustomed to working around previous surgical scars. However, the presence of scar tissue could affect the surgical approach, specifically the extent of dissection and liposuction on your left side. Your plastic surgeon will assess your abdominal wall integrity and skin elasticity to determine the best plan.

Considerations for Your Surgery: Scar tissue from your previous nephrectomy may pose a challenge during dissection, particularly when performing muscle repair or liposuction in the same area. Your surgeon will evaluate this carefully during a consultation.

While your kidney function is great and you have no underlying health issues, your surgeon may coordinate with your nephrologist or primary care physician to confirm that your single kidney can handle the demands of surgery and recovery, particularly with potential fluid shifts during the procedure.

Depending on the location and characteristics of your scar, your surgeon may adjust the extent of liposuction near the scar to avoid excessive trauma or risk of contour irregularities. Muscle repair can usually be done without issue, but it’s crucial to ensure the scar won’t limit the results of your tummy tuck.

What You Can Expect: While the tummy tuck scar will typically be placed low on the abdomen (just above the pubic area), your surgeon will account for your nephrectomy scar to ensure a smooth, aesthetically pleasing outcome.
Your recovery should be similar to other tummy tuck patients. However, scar tissue from your nephrectomy might cause slightly more discomfort on that side during the initial healing phase. A tummy tuck with muscle repair and flank liposuction can provide dramatic improvements in contouring and may even help smooth or revise your nephrectomy scar, depending on its location.

I recommend consulting with a board-certified plastic surgeon experienced in working with patients with prior abdominal surgeries. They will carefully evaluate your scar and create a tailored surgical plan to address your concerns while minimizing risks.

It sounds like you are an excellent candidate for this procedure, and with the right preparation, you can achieve beautiful, transformative results.

Sincerely,
J. Timothy Katzen, MD, FACS

If you have healthy kidney function and no other health concerns, then you should be able to have the tummy tuck and liposuction. The scarred areas can be dealt with and probably will not be an issue.