For women who don't need a great deal of skin removed (and a hip to hip incision), but need their muscles tightened and an umbilical hernia repaired, they may be a candidate for a hybrid tummy tuck.
The hybrid tummy tuck involves a C-section-type incision with full tightening of the deep fascia, the structure that holds the muscles. Although doctors often refer to tightening the muscles, it is in fact the fascia that is tightened.
The hybrid tummy tuck is not for women who have a great excess of skin and fat. Good candidates are typically fit moms. But for women who have only been offered a full tummy tuck and in fact have primarily a problem of the fascia, the hybrid tummy tuck is just the right thing.
Plastic surgeon should be able to fix both diastasis and umbilical hernia
You should seek an other opinion as a well trained plastic surgeon should be able to correct all of your problems at one operation. First, if you don't have enough skin for a standard tummy tuck with the incision around the belly button, you may consider a tummy tuck with an "Umbilical float". This allows the entire skin of the abdomen to be lifted and tightened and the excess trimmed off without having to make the closure too tight or incising around the belly button. The scar can be placed very low and be very well camoflouged. After the skin is elevated the diastasis and the umbilical hernia should easily be able to be repaired to flatten your tummy and restore its youthful contours. Seek out someone board certified by the American Board of Plastic Surgery.
A plastic surgeon who is also a general surgeon is what you need
What you have can be best repaired by a surgeon who is Board Certified in Surgery and also is Board Certified in Plastic Surgery. Wearing these 2 hats will enable the surgeon to best improve the aesthetics of your abdomen as well as repairing your hernia and tightening your rectus diastasis (the split between your rectus muscles). In fact, just last week, I repaired an abdomen and did a tummy tuck on a patient who is almost identical to what you describe.
If there are no surgeons who qualify with this degree of training in Idaho, there are several who do so in Washington state.
A tummy tuck is not a tummy tuck is not a tummy tuck....
A tummy tuck is not a tummy tuck is not a tummy tuck. While patients and surgeons alike use the term tummy tuck or abdominoplasty to indicate a particular procedure, in reality, it is best to analyze the anatomy of individual patients, discuss the desired results, and then design an operation to fit your particular needs. What you call the procedure is less important.
I have found that patients respond variably to pregnancy. Some have abdomens that are destroyed by one pregnancy and others, with five pregnancies, look virtually normal. You may have more muscle issues than skin, and it would be important to separate out the anatomical components of your concerns.
You may be a good candidate for a muscle repair to correct the diastasis recti and hernia without any skin excision or perhaps a so-called limited "mini" tuck or "modified" abdominoplasty.
Plastic surgery fixes stomach muscles and umbilical hernias!
It is always a matter of performing the right procedure for the right patient. When a significant amount of excess skin is present, a full abdominoplasty together with muscle repair and hernia correction is routinely performed. If the skin redundancy is minimal, a version of a mini-abdominoplasty is performed where the small amount of skin is removed, the muscles are repaired and the hernia fixed. Where no excess of skin is present, an endoscopic approach may be used where the muscles are repaired and the hernia fixed through a very small, well hidden incision.
Tummy tuck to fix torn muscles and hernia
I would recommend that you see an experienced plastic surgeon. In the usual tummy tuck, the excess skin and fat is removed (you probably have some looseness after 5 children), the skin is stretched (to make it tight), and the underlying muscle separation is repaired (along with any hernia).
Get another surgical opinion
The separation of the abdominal musculature (diastasis recti) and an umbilical hernia are routinely corrected during Tummy Tucks. I find it hard to believe that after five pregnancies you do not also have enough loose skin to warrant a Tummy Tuck. I would advise you to obtain another surgical opinion!.
ABdominoplasty (tummy tuck) for muscle repair
SEE VIDEO BELOW FOR MUSCLE REPAIR:
A timmy tuck involves differential repair and treatment of:
- localized fat
- redundant skin
- separated muscles (rectus diastasis)
In your instance you may need more aggressive treatment of the muscles with less attention to the skin and fat. This may result in a mini-tummy tuck or your own customized version of a tummy tuck.
I certainly would get a second opionion and maybe three to be made fully aware of your options. Choose the operation that fits your needs
A combination procedure would be best
My preference (as a general and plastic surgeon) is to fix the hernia using your own muscle tissue and tighten/repair the msucles at the same time. After that, the tummy tuck is done as usual.
I do not like to use plastic mesh to fix hernias because of problems with recurrence and infection, and my preference is to have control over the muscle repair because that is an important part of getting a nicely sculpted result.
What you likely have is what is called a "rectus...
What you likely have is what is called a "rectus diastasis", where the two rectus muscles of your abdomen (the muscles that make a "six pack") have widened and moved away from the midline of your body. This is quite common after pregnancy, and certainly after 5 pregnancies. Having an umbilical hernia as well is very common and we often fix them during tummy tucks.
Without having examined you personally, my guess is that while you may not have a lot of extra skin, you probably have some, and you almost certainly have significant laxity of your abdominal wall muscles. This means that you would likely be a good candidate for a tummy tuck.
When I examine a woman's abdomen, I'm looking at a few things:
laxity of the abdominal wall muscles
amount of excess skin
presence of excess fat
location and shape of the belly button
presence of any old scars (for example from a C-section or from abdominal surgery)
In many cases, the majority of the work and attention during a tummy tuck procedure has to do with the tightening of the abdominal muscles to help flatten the abdomen, improve its contour, and reconstruct those six pack muscles. Removal of excess skin is also important, but it's not the only issue that is corrected.
Bottom line: Just because you don't have a lot of extra skin doesn't mean you can't have a tummy tuck. I would recommend seeking a second opinion from a Board Certified Plastic Surgeon.
Best of luck! Dr. S