What are the complications of a tummy tuck revision with a mesh? Any other suggestions or advice? (photo)

Question

I am almost 11 weeks post DIEP Flap. I have had a significant bulge since day 1. The bulge is growing. When I lay down, my breathing is labored. I can’t sleep and I am miserable. My PS says weak fascia is the issue. He wants to do a revision surgery with mesh in a couple of weeks. I am very afraid of future complications with mesh but feel I don’t have any other option. Any advise or suggestions will be greatly appreciated.

Kenneth Hughes, MD · Answer

I have not used mesh in diastasis repair, and I have not even used mesh in hernia repairs.  The abdominal wall can usually be manipulated to provide reinforcement.  However, every patient must be evaluated as an individual. The bulge could be the result of fat movement during the DIEP Flap surgery, fascia laxity, or a fluid collection.  I would have to examine you in person to determine the reason.

Daniel Barrett, MD · Answer

Dear JBis,
in most cases,mesh is not needed for tummy tuck surgery because surgeon is able to perform muscle plication without it. In some rare cases when fascia is severely weak, mesh is used to do the plication. If you are considering a surgery, I would suggest you to consult a board-certified plastic surgeon. Only after a thorough examination you will get more information and recommendations.
Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Suresh Koneru, MD · Answer

Sorry to hear that you are having problems with your tummy after your DIEP flap.  There are many different meshes that surgeons use to reinforce a weak abdominal wall.  Complications vary depending on the type of mesh used.  I would ask your surgeon what type of mesh he plans to use and share your concerns with him.Generally speaking, there are very few long term complications with mesh placed above the fascia to reinforce the abdomen.

Richard P. Rand, MD, FACS (retired) · Answer

The DIEP flap shouldn't hurt the fascia the way a TRAM flap does. Weak fascia should not be causing a "growing" bulge at 11 weeks. It sounds much more like a seroma (fluid collection) and this can easily be diagnosed either by clinical exam or an ultrasound.

What are the complications of a tummy tuck revision with a mesh? Any other suggestions or advice? (photo)

Answers (4)

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