I am considering having a Tummy Tuck due to loosing approx. 70 lbs. over the past 2-3 years. The only concern I have is had 5 hernia repairs in the past, and recently diagnosed as a diabetic but manage on this with only the pills. I had a major hysterectomy 2 years ago and 3 weeks later developed a major infection that ended me up on a pick-line giving myself IV antibiotics at home for about 3 months to prevent my side to side mesh from having to be removed. What is your opinion? Will I still benefit from this procedure?
Will I Still Benefit from Tummy Tuck?
Doctor Answers 9
I wouldn't do an abdominoplasty or tummy tuck with your history
It is wonderful that you have lost 70 pounds! Congratulations.
Unfortunately you have a very complex history. With mesh in your abdomen from previous hernia repairs and the history of infection following the hysterectomy, my personal opinion is that the risk of an infection and wound healing problems following a tummy tuck or abdominoplasty is too high.
There is also the problem of previous scars on your abdomen which could interfere with wound healing.
I recommend that you be happy and proud about your weight loss and avoid the risk of very serious complications of a tummy tuck or abdominoplasty.
Diabetes and Tummy Tuck
1. Tight blood glucose control with diet, exercise, and medication. You need to see your internal medicine doctor regularly and make sure your diabetes is well controlled.
2. If you are overweight, then losing weight decreases your risk in tummy tuck surgery or any other surgery for that matter.
3. If you have high blood pressure, this needs to be managed and well controlled by your internal medicine doctor as well.
4. ABSOLUTELY NO SMOKING!
5. Consider with your surgeon HyperBaric Oxygen therapy pre- and post-op.
6. Make sure you understand from your surgeon and anesthisiologist what medications you should take or not take prior to surgery.
It is very possible to have a great outcome as a diabetic following tummy tuck surgery, but minimizing the risk is the most rational way of accomplishing this.
Pablo Prichard, MD
I don't think you are a good candidate for tummy tuck
Safety always comes first! Unfortunately, you have many risk factors against you stemming from multiple abdominal surgical procedures/complications and your overall medical health which is compromised by your diabetes. I think that an abdominoplasty is too risky. Keep it simple and rejoice with your new figure that you earned from your weight loss. I hope this helps!
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It complicated but possible
So the issue is that you have all this extra skin but an abdominal wall that has been operated on multiple times, diabetes, mesh and previous infections. "Well other than that Mrs. Lincoln how was the show?" Yes, you have many issues but nothing that can't be fixed with the appropriate planning.
First, your health has to be as close to perfect as it can for you. Meaning your HgA1C has to be normal as well has all of your lab work. Next you will need the abdominal skin flap elevated and the mesh, likely removed. If removed than it needs to be replaced with new. Lots of antibiotics. In addition with that many hernias your belly button may take a hit due to an already compromised blood supply. Even if it does die they usually scar in well.
With the right surgeon, planning and precautions you still have risk but it can be minimized.
You need abdominal wall reconstruction and not necessarily a tummy tuck
Your situation is more consistent with abdominal wall recosntruction rather than a traditional tummy tuck.
You are at a higher than average risk for wound healing problems, infection, multiple procedures, and complications.
I would strongly advise that you consider having this procedure in a hospital and possibly an inpatient setting.
Yours is a very complex situation
As you can see from the other excellent answers, your's is absolutely not a straight forward situaiton and there are many issues to consider. You need the very best plastic surgeon to evaluate you and tell you the honest truth about your risk to benefit ratio here. I would strongly recommend that you visit Dr. Barry Bishop in Greenville, SC and ask him his opinion. He is an outstanding plastic surgeon with vast experience. Good luck!
Not a simple question...
FIrst of all, congratulations on your weight loss. Losing 70 lbs will undoubtedly make some of your problems (diabetes) easier to deal with.
As for a tummy tuck, there are a number of issues which must be sorted out. You might be well served by a panniculectomy rather than a full tummy tuck. This would take away your apron of skin but not relocate your belly button. The procedure isn't necessarily cosmetic but would accomplish removing this extra skin while subjecting you to limited risk.
Again, a board certified plastic surgeon should be able to review these risks with you and make the appropriate suggestions.
Tummy Tuck after prior surgeries
You have a compicated history. IF you are to have a tummy tuck your surgeon must coordinate your care and get lots of information from the gynecologist, the general surgeon (if he was the one who repaired your hernias), the infectious disease physician, the endocrinologist or family doctor, as well as any hospital records to review exactly what was done at the time of the surgeries. You should only go to a surgeon with a vast experience in reconstructive surgery and this is usually a plastic surgeon. Plastic surgeons are well versed in complex reconstructive problems and can address whether it is even safe to do anything, and if it is, what is the best form of treatment. This may range from relatively simple abdominoplasty (tummy tuck), although this is unlikely with your history, to myocutaneous flaps (muscle and skin flaps), etc. Thsi is not something you want to rush into and must get as much information as possible. Yes it is possilbe to benefit but only your plastic surgeon can weigh the risks and potential complications and let you know what they are. Good luck!
Benefits of elective tummy tuck
Given your history of multiple hernia repairs, diabetes, persistent abdominal wall mesh, and major infection after previous abdominal surgery, my initial impression is that abdominoplasty, should complications arise, could lead to catastrophic problems. If you develop wound healing problems, which are more common in diabetics and patients with previous abdominal surgery, it could lead to infection, loss of the mesh, and possible recurrent hernia.
If you have a significant amount of loose skin of the abdominal wall from your weight loss causing superficial wounds or hygiene problems, you may or may not be a candidate for a conservative excision of skin. Ultimately, all surgery involves a risk-benefit analysis. An evaluation by a board-certified plastic surgeon would be very beneficial in determining whether the benefits of surgery outweigh the potential risks.
Best of luck!