Best Technique for a Tummy Tuck for Ehlers Dan Los?

Hi, thanks for posting your case.  My guess is that after 100 lbs of weight loss, you are very concerned about the excess skin and the laxity in your abdominal wall.  What types of issues are you having.  You will stretch after any body contouring procedures.  The main issue here is that your skin and abdominal fascia is genetically prone to laxity.  Despite this issue, body contouring can be successful in that you can resect the excess skin and tighten the fascia.  If you maintain your current weight, you will never return to the degree of laxity that you currently have.  Basically, if you do not gain weight again, the internal forces that will cause your abdomen to protrude (intraabdominal fat) will not return.  You will have stretching of the skin once it has been resected, but not to the degree that you currently have.  Additional measures for the abdominal wall may be valid if you have a frank hernia.

Hello,

Thank you for the question.  I have not performed a tummy tuck on a patient with EDS.  My best recommendation is to seek out support groups in your community that may have advice or recommendation of plastic surgeons who have performed body contouring procedures of EDS patients.  The more experience with this issue in terms of body contouring and healing the better.

All the best,

Dr. Remus Repta

Thank you for the question. This is a difficult problem to tackle. As you are aware of, this is a condition characterized by skin hyperextensibility, joint laxity, and friable tissues. Typical manifestations include dystrophic scarring and easy bruisability. These are as a direct result of the what becomes readily apparent tissue friability. There is poor purchase by the suture, which coupled with the laxity makes undermining of the soft tissues and their plication almost impossible. Other problems readily encountered include wound dehiscence, wide scar formation, and bleeding from small vessels which can be difficult to control.

While it is not impossible to operate on a patient with Ehlers-Danlos syndrome one should proceed with the utmost of caution. A frank discussion which includes the possible post operative complications secondary to Ehlers-Danlos syndrome and the benefits of the planned procedure must take place between the patient and their plastic surgeon.