Umbilicus nerve pain after tummy tuck?

Question

I had a full tummy tuck in 2022. This led to chronic constipation which led to hernia surgery in 2023. Then diverticulous. Then nerve ending pain at umbilicus when I get full or bloated even with just a little water, food. I'm Starving myself because it hurts physically to eat. I want to eat. Help!

Semih Yildiz, MD, FEPOBRAS · Answer

This needs prompt in-person medical evaluation. Pain around the belly button after a tummy tuck can sometimes come from scar sensitivity, nerve irritation, a small neuroma, or tight scar tissue. However, pain that is triggered by eating, bloating, or even drinking water, especially when it is making you avoid food, should not be assumed to be just a superficial nerve problem.

Given your history of chronic constipation, hernia surgery, and diverticular disease, you need to be assessed for abdominal causes as well. Possibilities can include recurrent hernia, scar tissue/adhesions, bowel motility problems, constipation-related distention, inflammation, or another gastrointestinal issue. A physical exam is essential, and your doctor may consider imaging such as an ultrasound or CT scan, plus GI evaluation, depending on the exam.

Please contact your primary doctor, GI doctor, or general surgeon soon, and also update your plastic surgeon. If you cannot eat or drink normally, are losing weight, feel dehydrated, have vomiting, fever, worsening abdominal pain, a hard or distended abdomen, blood in the stool, or inability to pass stool or gas, you should seek urgent care or emergency evaluation.

Once internal abdominal causes have been ruled out, then a focused exam of the umbilical scar can look for nerve entrapment or a painful neuroma. Treatments may include desensitization, medication for nerve pain, targeted injections or nerve blocks, or scar revision in selected cases, but those should come after the more serious abdominal causes are excluded. The most important point is that you should not have to starve yourself to avoid pain; this deserves medical workup.

J. Timothy Katzen, MD, FACS · Answer

Hello RSProfile3960692. Thank you for your question regarding the nerve pain you are experiencing at your umbilicus following a series of abdominal surgeries.

It sounds like you've had a challenging time with complications following your full tummy tuck in 2022, including chronic constipation, hernia surgery, and issues related to diverticulosis. The nerve pain you describe when you eat or drink even small amounts can be particularly distressing.

Possible Causes and Next Steps:

Nerve Entrapment: It's possible that during one of your surgeries, abdominal nerves, particularly around the umbilicus, may have been entrapped or irritated. This can cause significant discomfort when the abdominal area is stretched, such as when eating or drinking.

Scar Tissue: The formation of scar tissue post-surgery can also contribute to discomfort and pain, as it may lead to adhesions that tug on the surrounding tissues and nerves during physical movements or digestion.

Consultation with a Specialist: I recommend visiting with a pain management specialist or a surgeon who specializes in abdominal and nerve-related issues. They can provide a thorough evaluation to determine the exact cause of your pain.

Diagnostic Tests: Imaging studies such as an MRI or abdominal ultrasound might be helpful to visualize any potential nerve impingement or significant adhesions.

Treatment Options:

Medication: Pain relief through medications that specifically target nerve pain, such as gabapentin or pregabalin, may be beneficial.
Dietary Management: Working with a nutritionist to modify your diet to prevent bloating and ease digestion can also help manage the pain.
Surgical Intervention: If there is a specific anatomical cause identified, such as entrapped nerves or severe adhesions, a corrective surgery might be necessary.
Therapy: Physical therapy specializing in abdominal rehabilitation could potentially help in alleviating some of the pain by strengthening the surrounding muscles and improving flexibility, thus reducing pressure on the affected nerves.

It is important not to starve yourself as proper nutrition is crucial for your recovery and overall health. A specialized diet that minimizes bloating and maximizes easy digestion might help alleviate some of your discomfort while ensuring you receive adequate nutrition.

Follow-Up Care: Continual follow-up with your healthcare provider is essential to monitor your condition and adjust treatments as necessary.

I hope this advice helps you find some relief and answers soon. Please take care and make sure to follow up with the appropriate specialists to address this complex issue comprehensively.

Sincerely,

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

Camille Cash, MD · Answer

Nerve pain beginning two years after surgery is likely not related to your tummy tuck.  I encourage you to visit with your GI specialist for an evaluation.  Nerve pain can be treated numerous ways, including management with medication if indicated.

Serkan Kaya Ekinci, MD · Answer

There is no situation to panic. The period after the tummy tuck surgery, that is, the pain you feel, is not due to the incision, which is already numb after the surgery, but the source of this pain you feel is due to the stretching of the repaired muscles in the midline. Since the core muscles that are stitched together from the breastbone to the pubic bone (diastasis recti repair) hurt, I think you feel pain during normal activities such as standing upright, climbing stairs, getting up from a sitting position or out of bed.I did not examine you, but when the complaints from my own patients are common, I would like to give you information as I explained to them. Think of it this way: A tummy tuck is basically fitness boot camp for the abs. Those stubborn muscles loved the relief of your flabby belly with you. They try to adapt to the environment by acting sore and tired for about a week. These muscles tire quickly due to the layers of stitches placed to keep them tight. There is nothing to worry about. The pain will subside after a week and you will start to think about it less. I hope I could help .

Mats Hagstrom, MD (license on probation) · Answer

To make an assessment regarding the outcome of any plastic surgery procedure, we need to see a complete set of proper before and after pictures.
There is no correlation of having diverticulosis and cosmetic surgery.
Based on what you describe my best guess is you have excess visceral or intra-abdominal fat.
When that’s the case, muscle tightening during a tummy tuck will cause an increased intra-abdominal pressure unless the patient loses weight.
Excess visceral fat is the number one reason patients have symptomatic complaints of abdominal discomfort and other issues after this procedure.
It can usually be easily detected on before pictures and should have been assessed during your in person consultation.
Individuals who have excessive visceral fat should be told they need to lose weight before being a good candidate for tummy tuck surgery.
Your outcome is probably much more related to your candidacy for the procedure than the surgery itself.
My best guess is successful weight loss will relieve your symptoms.
These are obviously assumptions because we were not presented with much detailed information about your surgery. 
Consider reposting with proper before and after pictures or schedule a few in person second opinion consultations with other plastic surgeons in your community.
Best,
Mats Hagstrom MD

Umbilicus nerve pain after tummy tuck?

Answers (5)

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