Would getting a tummy tuck help with chronic hip and back pain?

Question

I am 67 year old female with chronic back and hip pain. I have a big, flabby tummy from having 5 children and poor exercise habits. My back pain is getting so much worse and I don't sleep much because of pain (I refuse dependence on ibuprofen). I get backache relief when I use a corset or brace so I am thinking a Tummy Tuck would help. Although I have no major health concerns, is my age going to be a concern? I have tried cortisone/steroid shots to no avail.

Anita Patel, MD, FACS · Answer

Relieving any chronic back pain or hip pain would require treating the source of the pain itself. A tummy tuck is not considered a cure for back pain. That being said, your posture does have an effect on back pain, and if a tummy tuck helps improve your posture, it may indirectly help your back pain. This is probably why the corset or brace helps, since it holds in the tummy and helps correct your posture. (Also, if the pannus is large enough and heavy enough to cause a strain on the back, this could be contributing as well, though in this case weight loss is a good start before surgery, and/or going for panniculectomy until your goal weight, and then doing a tummy tuck.) Also, part of a tummy tuck is repairing any diastasis recti (or muscles that have separated and not returned to their pre-pregnancy state), and this too could have an indirect effect. Age alone is not a contraindication to surgery. It is your overall health status and mobility that it important. The biggest risk of the surgery is getting a blood clot from not being active after surgery, and this can be a life threatening matter. I would require a medical clearance, labs, and EKG prior to surgery to make sure you are in good shape for surgery, and I would recommend aftercare for at least one night after surgery if done in an outpatient surgery center, or an overnight stay if done in a hospital setting.

S. Larry Schlesinger, MD, FACS · Answer

Thank you for this excellent question.  It needs to be answered carefully and thoughtfully.First and foremost, cosmetic plastic surgeons engage in surgery that improves one's appearance, thereby improving one's self esteem.  Often there is a functional byproduct to these surgeries, but the functional improvement is an incidental byproduct but not what any surgeon would promise.  For instance, many plastic surgeons will harvest cartilage from the septum of the nose to use in beautifying the nose.  However, the removal of the septal cartilage often improves one's breathing.  There was a study done several years ago in Texas which showed that 23 out of 24 women having tummy tucks had a decrease or elimination of low back pain.  The repair of the rectus diastasis (separation of abdominal muscles) gives a balance to one's core leading to decreased strain on the lower back muscles.  Therefore, abdominoplasties, in my experience, very often decrease low back pain in post pregnancy females, but this should never be the reason one has the surgery since there are no guarantees.Depending on your health, 67 years old is certainly not too old to have a tummy tuck for aesthetic reasons.  If you were my patient, I would recommend a complete workup to eliminate other treatable causes of your hip and back pain.  Once other treatable problems are eliminated, I would discuss with you the benefits of a tummy tuck but make no promises as to the ability of the TT to eliminate your musculoskeletal problems.The TT will correct your "flabby tummy", improve your appearance, and help strengthen your core leading to an increased ability to exercise which may have a salutary effect on your musculoskeletal pains.

Dallas Buchanan, MD · Answer

Thank you for your questions. The purpose of a tummy tuck is to remove excess skin and fat from the lower abdomen to improve the contour and appearance. There is no indication that it improves or has any effect on back pain. I would address your back pain with your primary physician and get appropriate referrals to deal with that issue....cosmetic surgery is not your answer.Hope this helps!

Kenneth Hughes, MD · Answer

Age is not a contraindication by itself.  I have operated on patients in their 70's with no problems.  To have this surgery, you want to be in your best health and well nourished so that you can heal well and get a great result.  Although it is conceivable that a tummy tuck may improve the ability to strengthen the abdominal musculature, chronic back and hip pain should be addressed by a neuro or orthopedic surgeon.Kenneth Hughes, MD, Board Certified Plastic SurgeonLos Angeles, CA

Daniel Barrett, MD · Answer

Dear ebebryan,your age should not be a problem unless you have some serious problems. Tummy tuck will remove the excess skin which might reduce the pressure on your lower back and hips and relieve the pain but it is hard to predict. I would suggest you to consult a board-certified plastic surgeon. You will get the best recommendations after a thorough examination.Daniel Barrett, MD, MHA, MS 
Certified, American Board of Plastic Surgery  
Member, Am. Society of Plastic Surgery

Hayley Brown, MD, FACS · Answer

Tummy tuck surgeries are generally cosmetic in nature. People have back pain as they age for many reasons and a protuberant abdomen is probably the least likely to cause it. It is an invasive procedure with risk and downtime. If you are a normal weight, healthy, and a nonsmoker, you can get some consults and see what the plastic surgeons say. Sometimes patients  do feel postural improvements and some relief when the core is tightened but I wouldn't go into it expecting that.

Francesco Campanile, MD · Answer

After having five children, it's likely that your abdominal muscles have separated, a condition known as diastasis recti. As long as these muscles remain separated, your core strength, which supports your back and posture, is negatively affected. During a tummy tuck, your plastic surgeon can repair and tighten your abdominals, giving you a firmer foundation to support your spine and the rest of your body. Your age should not be a concern as long as you're in good health overall and are within a normal weight range for your height.

Jeffrey H. Lee, MD · Answer

If you have a large overhanging excess abdominal skin and fat, it may be causing your back pain but to be honest, it's unlikely.  If you came to me, I would recommend weight loss and consulting with a pain physician.  If you wanted an improvement of your abdominal contour, you would need to be assessed for an abdominal contour improvement procedure but I would never tell you that it would help your pain.  I suppose there is a chance that it would help but I would never operate on someone with the hopes of helping their back/hip pain.

Jared Troy, MD · Answer

It is possible to have some improvement in back pain with a tummy tuck and repair of separated muscles (diastasis repair) by theoretically adjusting the abdominal wall and musculature. However, this is more anecdotal and has not been studied with any certainty. This is not a selling point for this operation, but can be a pleasant bonus if it happens.

Tom J. Pousti, MD · Answer

Thank you for the question.
   Part of the tummy tuck operation involves plication (re approximation) of the abdominal wall muscles that have spread with pregnancy. This reconstruction likely strengthens the core and MAY help with issues such as lower back discomfort (assuming there are no other  anatomic causes of the lower back pain).  I would caution you however not to assume that your lower back pain will be resolved after tummy tuck surgery (in other words, it would be a good idea to have your lower back and hip pain worked up prior to undergoing abdominal wall surgery).
Best wishes.

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