Tummy Tuck for Patient with VP Shunt?

Thank you for your question regarding having a tummy tuck while having a VP (Ventriculoperitoneal) shunt. While it is possible to undergo a tummy tuck with a VP shunt, there are important considerations to keep in mind, and your surgical team will need to take special precautions.

A VP shunt is a device that helps drain excess cerebrospinal fluid from the brain into the abdominal cavity, where it can be absorbed by the body. Given that the shunt is placed in the abdominal area, where the tummy tuck procedure will occur, it is critical to ensure that the shunt is protected and that there are no complications during surgery.

During a tummy tuck, the surgeon will remove excess skin and fat, and may repair diastasis recti, which is the separation of the abdominal muscles. The presence of the VP shunt does not automatically disqualify you from having a tummy tuck, but it does mean that your surgeon will need to work closely with your neurologist or neurosurgeon to ensure that the shunt is not compromised.

Here are a few key points to consider:

Shunt Positioning: Your surgeon must be aware of the exact location of the shunt and its tubing. Care will need to be taken to avoid damaging or displacing the shunt during surgery.

Post-Surgical Fluid Management: A tummy tuck can sometimes lead to seromas (fluid buildup), and with a VP shunt, there may be extra considerations regarding how fluid drains in the abdominal cavity. This should be carefully managed.

Blood Pressure: Since you’ve mentioned that your blood pressure is sometimes high, it’s important to have this under control before surgery, as both general anesthesia and surgery can affect blood pressure. High blood pressure could increase the risk of complications like bleeding.

I strongly recommend consulting with both your plastic surgeon and the specialist who manages your VP shunt. By working together, they can determine the safest plan for your tummy tuck. As long as your medical team is well-informed and experienced, a tummy tuck is not necessarily ruled out by your condition.

Good luck! I hope this helps answer your question.

Sincerely,
Dr. Katzen

In addition to clearance from your neurosurgeon, your plastic surgeon needs to see 2 xray films of your abdomen called a KUB with a lateral view. This will alert him or her as to the actual course of your shunt before surgery and provide an important "road map."
Some shunts are tunnelled deep, near the muscles, and are easy to avoid. Others may be very superficial, just under the skin, and could be kinked or otherwise affected by the tummy tuck.
VP Shunts also vary as to where they enter the abdomen...some are down low, others are above the belly button.
Shunts also have a variable legnth of tubing that is left coiled inside the abdomen, and the last thing you want is for that to get pulled out. Shunts placed during childhood are more prone to being short.
Bottom line is your operating surgeon needs a few simple xrays to avoid surprises in surgery, and you need to be aware that any neurological changes after surgery could be from a blocked shunt, and you'd need to get a "shuntogram" done by your neurosurgeon if that occurred.

Hi Luvmylyfe - A tummy tuck may interfere with your shunt, so verify the position of the shunt with your neurosurgeon before surgery. Have the neurosurgeon talk to your plastic surgeon to detemine the shunt location and whether or not it can be removed prior to the procedure and replaced immediately after. Otherwise, if you're cleared medically by your internist you should be okay.

I concur with my colleagues that this is a unqiue scenario. First, I would recommend clearance from your neurosurgeon and an internist (given your blood pressure issues). I would also recommend an evaluation of your tummy by a board certified ASPS member plastic surgeon. With the proper workup and evaluation, I believe a tummy tuck may be a great option for you.

The first person you need to check with is your neurosurgeon. Repairing the diastasis will increase the pressure in the abdomen. Will this affect the fluid drainage? If your neurosurgeon says that the increased pressure will not be a problem with the shunt then you can proceed. Your plastic surgeon should be able to modify the procedure as needed given the shunt and the previous surgery.

Absolutely. You should be able to have the operation.
You have a normal BMI of of 22 and had 2 full term pregnancies AND C-sections. Unless there are other, unstated medical conditions, there is no reason why you should not be able to have a Tummy Tuck. As a matter of fact, I did such an operation less than two years ago on a woman with a VP shunt who was larger than you.
The key is to find out where the VP shunt goes from being under the skin to entering the tummy (which is usually in the upper left side of the tummy). The surgeon would need to carefully lift the skin/fat tummy flap to that point and carefully deal with the shunt when repairing the muscle separation (diastasis recti). ( This is similar to the operation we do in people who lost a lot of weight with a Lap Band. In this case the procedure is easier because the Lap Band reservoir can be felt through the skin while in your case the VP shunt may not be easily felt through the skin unless you are very thin).
See several Plastic surgeons (www.PlasticSurgery.org) and see what they each say.
Dr. P. Aldea

This is certainly a unique situation and as long as the shunt will not be interrupted in the procedure or is in the way of the proper conduct of a tummy tuck, I imagine it could be done. On the other hand, I am concerned by your comment that your abdomen is "hard" since usually, the abdomen is soft and flaccid in a good candidate for a tummy tuck. Visit with some plastic surgeons for an exam and ask your neurosurgeon.