Is tummy tuck revision surgery a high risk operation? 10+ yrs ago I had a TT w/muscle repair after having 3 big babies. (photos)

Question

The scar is higher than I expected and slightly tethered. 3 years ago the muscle repair became undone. I had an umbilical hernia & the Diastasis Recti had returned, I was offered keyhole surgery on the NHS to repair these, but was told that KH surgery doesn't have the longevity of open Surgery. It has now become undone again, and I have the DR & umbilical hernia again. I consulted a PS via the NHS & was told that the previous surgeries will have compromised the blood supply to the scar area and therefore it would present a high risk of healing problems and infection. Please could you advise me.

Ahmed Abd EL Gawad, MD, FEBOPRAS, FRCS(Plast) · Answer

Hi, thank you for sending your question and photos. I would be delighted to offer my advice. 
Your scar is too high and you don't seem to have to much excess skin. Lowering the scar to the right level may or may not be feasible. 
In terms of your previous key hole hernia repair, I agree with my colleagues who mentioned mesh repair but It needs to be done ON-LAY and not as the previous key hole procedure. 
Please consult your surgeon to clarify.  
I hope this helps.

Camille Cash, MD · Answer

Revision surgery is a bit more challenging than the primary surgery.  However if you are in general good health and otherwise a candidate it is certainly possible to safely have a revision to your tummy tuck including muscle repair.

Fulvio Urso-Baiarda, MD, FRCS(Plast) · Answer

Hi
I don't agree at all that a revision tummy tuck is high risk due to blood supply - that makes no sense. Since the skin flap has already been raised before, it has already developed preferential blood supply from the right direction and would actually be MORE robust the second time (this is called the delay phenomenon and has been well known by Plastic Surgeons for a long time!). Its an operation I do quite regularly and is very satisfying. However in the current funding climate I am not at all surprised that you are seeing resistance from the NHS.
Good luck, 
Fulvio

Tom J. Pousti, MD · Answer

Thank you for the question and pictures. Of course, nothing replaces in-person evaluation but, generally speaking, this type of revisionary surgery would not be considered "high risk". Obviously, this is assuming careful selection of plastic surgeon and expert planning/execution of the procedure.   Best wishes.

Melih Erogul, MD (retired) · Answer

Hi and welcome to our forum!
Abdominoplasty revision is not uncommon. It is often performed after a post-abdominoplasty pregnancy or after disruption of a diastasis repair. It is not considered a high risk procedure. 
However, you underwent initial repair which failed, followed by revision, which also failed. Some individuals have weak connective tissue. Have there been any weight gain issues, stretching out the repair? 
I recommend you obtain a second opinion regarding this issue. Perhaps you require mesh reinforcement of another repair.
Best wishes...

Is tummy tuck revision surgery a high risk operation? 10+ yrs ago I had a TT w/muscle repair after having 3 big babies. (photos)

Answers (5)