I recently welcomed my daughter into the world via c-section. (My second c-section). The doctor created a new incision approx. 1-1/2 inches below the first site. I had told her my first one got infected.
Once she began creating the new site she informed me my uterus is completely wrapped in scar tissue and is now attached to my abdominal wall.
I plan on having a Tummy Tuck later this year after I get my body in better shape. How will my two incision sites and the attached uterus be addressed?
Thank you for your question. It would be unusual for the wall of your uterus to be attached to the skin and subcutaneous fat after C-section. You need to discuss the specifics with your obstetrician and ask if the uterus adhesion is underneath the abdominal wall muscle. If the uterus is attached to the under surface of the abdominal wall muscles then you could consider having a Tummy Tuck.
However full and clear communication between the findings of your obstetrician and your chosen plastic surgeon are essential to make this decision.
Be sure to consult a plastic surgeon who is certified by the American Board of Plastic Surgery, experienced and has a good reputation in your community.
Web reference: http://drseckel.com/boston-tummy-tuck/boston-tummy-tuck-how-to-decide-if-you-need-an-abdominoplasty/
I believe this case involves good communication between your plastic surgeon and your OB-GYN to determine what is really meant by the uterus is "stuck to the abdominal wall". Once that bit of information has bee discussed and worked out then the plan for your tummy tuck can be discussed with you. If there are true concerns about the uterus then this may be address simultaneously with the tummy tuck by your OB-GYN.
It best to get everyone to talk.
Hope this helps.
Dr. ES
A few comments.
"uterus is completely wrapped in scar tissue and is now attached to my abdominal wall" - Every surgical incision results in a column of adhesive scar tissue which spans and unites the skln surface, where the incision began, to whatever the deepest structure the surgeon handled, in your case, the uterus. This "ONE INCISION - ONE SCAR" concept put forth by Dr. E. Peacock of North Carolina is applicable in EVERY surgery case.
While it makes a patient feel better that her post-surgical pain are explicable by this seemingly "special" scar status - your situation is NOT unique. All Plastic surgeons who do a fair amount of Tummy Tucks have encountered many women with similar conditions. while the scar tissue between the skin and the muscle lining / fascia makes the separation slow initially, it has no bearing on the cosmetic results of a tummy tuck.
For the best result, the Plastic surgeon would need to place his tummy tuck incision BELOW your 2 C-section scars and hide it in the area of your underwear. In this way, these old scars would be removed with the excess skin of the lower tummy.
To learn everything you need to know about Tummy Tucks and Mommy Make Over, follow the comprehensive link below -
Dr. P. Aldea
The management of your scars depends on how low they were placed as well as the amount of skin laxity and level of the umbilicus.
If you have a low lying belly button with sufficient skin laxity, you could undergo removal of both c-section scars replacing them with one scar that could be potentially conceaed beneath undergarments. The tethered uterus will likely play little role in the procedure unless you have a coincidental incisional hernia.
You can join the 2 incisions from the C-sections into one and with the help of a GYN doctor address the uterus during a full tummy tuck. Go see 3 boarded plastic surgeons for full details. Regards.
Anytime you have a previous surgery, it makes subsequent surgeries more complex. If you just had the two low scars, then it really is not a significant problem. Since you have a previous infection and internal scarring, then you really need appropriate workup before any surgery. In all likelihood, you should be fine since an abdominoplasty (tummy tuck) does not involve entering your abdominal cavity. It may, however, be a good idea for your plastic surgeon to discuss your case with your Ob/Gyn to make sure there are no other issues. Good luck.
Web reference: http://www.ShaferPlasticSurgery.com
First of all, you should directly inquire about these concerns to your plastic surgeon who should discuss your uterus issue with your obstetrician. Your uterus main be an incidental concern and may not need to be addressed surgically. If there is a surgical treatment, this can be coordinated with your plastic surgery. Your scars should easily be combined into one since they are so close together. However,this may change the approach your surgeon makes regarding your abdomen especially if your scars are quite low or even into the hair-bearing pubic region. Don't be afraid to bring up these topics for discussion.
These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.
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