Regarding: "Tummy Tuck w/ Colostomy?
Had colostomy for over 10 years.. The skin on the lower party of my stomach is so bulged out and have so much extras skin that my ostomy keeps pushing off. So my surgeon is doing a tummy tuck to take the extras fast or and skin to make my stomach flat again. But do you have to fix the abdominal wall so it will stay flat or will it work just taking or the fast and extra skin.."
As I understand your question you have a colostomy (? location on abdomen) but do to lower abdominal bulging the stoma bag keeps becoming detached. This prompted your GENERAL surgeon to propose removing the excess under the skin fat and redundant skin to flatten the lower tummy bulge. You are wondering IF in addition to taking excess skin and fat a correction of the abdominal wall is needed.
Many Board Certified Plastic surgeons, myself included, have fully trained and certified in SURGERY, prior to completing our training in Plastic Surgery and we have more than a passing knowledge of what our General Surgery colleagues are thinking and doing. There is NO way your question can be answered without a review of your records and an examination.
Colostomies are done for multiple reasons and can be temporary or permanent depending on the reason for putting them in.
No surgeon would advise doing a Tummy Tuck, a purely discretionary, cosmetic operation intended to improve the appearance of the tummy, in a patient with a colostomy. Doing so WILL be associated with spreading bacteria found in human waste throughout the operative field resulting in life-threatening complications. I am therefore inclined to believe that you and your surgeon had a miscommunication.
Bulging of the lower tummy, especially in patients with a history of Colostomy or other abdominal surgery, suggests either a weakness of the abdominal muscles OR a PARASTOMAL hernia, where bowel pooches out along the opening. Both of these are fairly challenging surgical conditions.
I suggest you speak to your surgeon again.
Dr. Peter Aldea