63 years old- Debilitating pain from 6 weeks post abdominoplasty and muscle plication. Can plication be taken down?

Question

Hello can anyone help please? I am almost 7 months post surgery and suffer crippling pain every day that has greatly impacted on daily life. Age 63 healthy female. The pain is to the right of my umbilicus but also directly below it, mid central. Burning in nature, the muscles feel extremely tight within minutes of standing up and the only relief is by laying back down despite physio to try to aid relief. It has been suggested I may have nerve entrapment. Can plication be taken down?

J. Timothy Katzen, MD, FACS · Answer

Thank you for your question regarding crippling abdominal pain throughout your tummy tuck incision. I’m sorry you’re having so much pain. Since the pain began after your tummy tuck and it is in the area of muscle plication, I would strongly suggest that you have the plication taken down. Since you were having problems with a plication, I suggested removing all of the sutures. I would not even suggest slight plication due to the swelling and the scarring in the area. During muscle plication, I perform a two-layer plication with a permanent suture from the bottom of the sternum to the top of the pubic region. I use permanent sutures so they will not dissolve. If you have extreme pain after the plication, you should be assumed it is due to the plication. Therefore, in my opinion, I strongly suggest you have the plication taken out as soon as possible. Good luck.

Sincerely, Dr. Katzen. (“Verified” Plastic Surgeon, President of the American Society of Bariatric Plastic Surgeons, certified by the American Board of Plastic Surgery, Fellow of the International Society of Aesthetic Plastic Surgery, American College of Surgery, and International College of Surgery, and member of the American Society of Plastic Surgery, American Academy of Cosmetic Surgery and RealSelf Hall of Fame.)

Sincerely, Dr. Katzen. (“Verified” Plastic Surgeon, President of the American Society of Bariatric Plastic Surgeons, certified by the American Board of Plastic Surgery, Fellow of the International Society of Aesthetic Plastic Surgery, American College of Surgery, and International College of Surgery, and member of the American Society of Plastic Surgery, American Academy of Cosmetic Surgery and RealSelf Hall of Fame.)

Stefan Mark Szczerba, MD · Answer

I'm sorry to hear you're having issues!!  Tummy Tucks are supposed to be fun.  Ok so how to proceed...I would check in with your surgeon or get the operative report.  I would want to know if the sutures are absorbable... if they're absorbable I recommend just waiting.  Absorbable sutures will relax and get replaced with scar tissue - that may not have the same pain issue that a suture may be creating.  If they are permanent, the yes consider taking the plication down.  Best Wishes!!!

Daniel Barrett, MD · Answer

Dear Generous916803,
I understand your concern. However, without a proper assessment, it would be difficult to determine what went wrong. It is best that you visit your plastic surgeon for further assessment or ask for a second opinion. Only after a thorough examination, you can get proper recommendations and advice.
Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Camille Cash, MD · Answer

I'm sorry that you are having so much pain 6 months from surgery.  I encourage you to discuss your concerns and considered options with your surgeon.  If it is nerve entrapment there are medications that bring relief as you decide next steps.

Mats Hagstrom, MD (license on probation) · Answer

At this point you are completely healed and the scar tissue on your abdomen has matured. I’m doing the procedure is difficult and I’m not sure it would relieve your discomfort.

Every once in a while we get patients who have ongoing pain after this procedure. Typically it gets better with time. Consider physical therapy or talking to a pain management physician.

Best,

Mats Hagstrom MD

Jose A. Munoz, MD - Account Suspended · Answer

Hi and welcome to our forum!It is not a normal postoperative phenomenon to experience severe pain 7 months after abdominoplasty. If at all possible, the source of the pain might be determined through careful examination, looking for a neuroma or nerve trapped in scar. An overly tight plication may result in loss of respiratory reserve with resulting shortness of breath. If pain management modalities have failed you, and if the source of your pain cannot be determined, exploration of the surgical site may be required. Taking down the plication is performed if no other source can be identified.Continue follow up with your plastic surgeon.Best wishes...

63 years old- Debilitating pain from 6 weeks post abdominoplasty and muscle plication. Can plication be taken down?

Answers (6)

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