Tummy tuck after hysterectomy - how soon? Also, should I lose weight before tummy tuck? (Photo)

43 y/o, 5'3", 145 lbs, 3kids, 1 c-section, 5wks post op hysterectomy. How soon can I have TT? Also, I lost 45lbs by diet & exercise in '14. Have lots of loose skin. Lowest at 130 last yr but dx with rhabdomyolysis in Nov 2015. No exercise of any kind since then due to spike in CPK. P is also always critically low. Currently 145lbs. Should I lose weight before tummy tuck for optimum result. Also, I'm on lifetime xarelto due to svc syndrome - dx in 2008 post chemo for DLBCL NHL. Is it safe? TY!

Doctor Answers 11

Tummy tuck after hysterectomy - how soon? Also, should I lose weight before tummy tuck?

You have to discuss this in detail with your plastic surgeon, and get more than one doctor's consultation. Also consult with our doctor treating rhabdomyolysis and your xarelto. Your situation is complicated. Take your time to evaluate with all your physicians.


San Francisco Plastic Surgeon
4.4 out of 5 stars 7 reviews

Yes it is safe...

Based on the photos you seem to be a good candidate for tummy tuck and some liposuction.  However, you should be at your best weight and have good habits (eating and exercise) before thinking of tummy tuck.  Also, since you recently had hysterectomy you should wait at least 4 to 6 months from your surgery date.  Choosing a plastic surgeon in your community is easy, just review their before/after photos to see if you like their work and make sure that they show you at least 6 views from each patient (front, quarter turn, profile, back, and sitting views).

Andre Aboolian, MD
Beverly Hills Plastic Surgeon
5.0 out of 5 stars 56 reviews

Find the right surgeon to help you decide

Far more important than deciding if TT is for you is the skill and experience of your plastic surgeon. Choose your surgeon rather than the technique and let him explain why one technique may be better than another and if you need a tummy tuck. Many board certified plastic surgeons provide a free first time consult and you should take advantage of that! See the below link on some suggestions on finding the most qualified Plastic Surgeon for you!

Surgery

Thank you for the question and obviously weight loss prior to surgery if you plan to maintain that weight is a good idea.  I would also get clearance from my internist piror to surgery and then have him work with your plastic surgeon on stopping and staring xarelta


Dr. Corbin

Frederic H. Corbin, MD
Los Angeles Plastic Surgeon
4.9 out of 5 stars 60 reviews

Tummy tuck

Best to get a good medical clearance from your medical doctor prior to having a tummy tuck.   I take care of patients all the time on Xarelto.   Just need to make sure you are cleared for surgery and stop the blood thinner prior to the surgery and start back up when your doc feels it is appropriate.  I work with the primary docs on determining this.   Best to go to a board certified plastic surgeon.

Andrew T. Cohen, MD
Beverly Hills Plastic Surgeon
5.0 out of 5 stars 37 reviews

Abdominoplasty

Hello,

Assuming that obesity is not an issue, weight loss is only important prior to abdominoplasty if there is substantial intra-abdominal fat stores causing abdominal wall (muscle) fullness. This can be easily determined during the physical examination, however you do not appear to need to loose weight. I question your need for Xarelto, as your original clot occurred because of cancer.  You are no longer hypercoagulable, and can certainly go off of it long enough prior to surgery. Some important points to consider regarding this procedure: 1. The incision and subsequent scar has an optimal placement at the thigh-abdominal border laterally, and no more than 2 cm above the labial commissure in the pubic area. This will be the most inconspicuous place for this long, horizontal incision. The small hole made by detachment of the abdominal skin from the belly button can be closed vertically if that portion of the skin cannot be excised; this is far superior aesthetically than placing the long horizontal incision too high on the abdomen.  2. The abdominal skin flap should be de-fatted by liposuction and/or direct excision of deep fat; this will not only contour your abdomen better, it will remove the 'parasitic' fat that steals the circulation from the skin. 3. Progressive tension sutures should be placed not only to optimize skin tension along the entire belly, but to also obliterate the space under the skin, obviating the need for drains and minimizing your risk of seromas, the most common complication of the abdominoplasty. At 5 weeks post c-section, you can start the consultation process. Go visit a few ABPS certified/ASAPS member surgeons. Best of luck!

Gerald Minniti, MD, FACS
Beverly Hills Plastic Surgeon
4.9 out of 5 stars 79 reviews

Tummy tuck after hysterectomy - how soon? Also, should I lose weight before tummy tuck?

Thank you for your question. Your medical issues will have to be stabilized and carefully reviewed with your internist and selected board-certified surgeon before proceeding with any surgery or anesthesia.  Aside from that, my recommendation would be to wait a minimum of four months or preferably six months to allow resolution of swelling before proceeding with a tummy tuck.  The best timing would be based on a combination of achieving a maintainable and healthy weight as well as your physical exam showing completion of healing from your hysterectomy.  My guess is that this would occur at about six months.


Simply from your history of three pregnancies, a hysterectomy and a review of your photographs I think you can look forward to a dramatic improvement from a full tummy tuck when the appropriate time arrives. Best of luck and good wishes,

Jon A Perlman M.D., FACS
Diplomate, American Board of Plastic Surgery
Member, American Society for Aesthetic Plastic Surgery (ASAPS)
ABC-TV Extreme Makeover Surgeon
Beverly Hills, California



Jon A. Perlman, MD
Beverly Hills Plastic Surgeon
5.0 out of 5 stars 30 reviews

How soon for TT after hysterrectomy?

Wow.  Lots of questions.

First, regarding timing alone, it would be best to wait until everything (eloectrolytes, blood counts, protein balance) has returned to normal following your prior surgery.  It is also best to wait until the scar tissue from the hysterectomy has softened.  So, general rule of thumb, wait until at least 3 months post-op and preferably 6 months.

Second, regarding weight, it is generally best to get as close as reasonably possible to your ideal sustainable weight before surgery.  Your result will be better and longer lasting.

Third, regarding your anti-coagulation with Xarelto, I assume this issue was addressed in the peri-operative period of your hysterectomy.  Basically, the same guidelines would be followed for TT surgery.  The difference is the procedure would a bit longer and bloodier.  It would be best to discuss the risks with your Hematologist/Oncologist and decide whether they are reasonable for a procedure that is purely elective.

Best of luck.


Tummy tuck after hysterectomy - how soon?

Wow!  You have used more abbreviations in your post than I have seen before! 


Short answer; given your complicated past medical history, only your internist (or doctors who know you best) will be able to provide you with good advice when it comes to whether or not you should undergo elective abdominal wall contouring surgery (and when).   There is obviously a lot to consider…


 Although you certainly do not seem overweight, it is always best to be as close as possible to long-term stable weight prior to proceeding with abdominal contouring surgery.


 Best wishes.

How soon after hysterectomy can tummy tuck be performed?

Your question is a frequently asked one. Generally, at least 6 or more weeks should elapse before undergoing a tummy tuck. The bigger issue is whether you are a good candidate for an elective operation given the health matters which you possess, including the use of a prescription blood thinner and SVC syndrome. Providing that your post-surgical recovery from hysterectomy was uncomplicated, then tummy tuck, which does not enter the abdominal cavity but does requires a general anesthetic, should be safe.  To get a really detailed answer to your question, plan to consult a Board Certified plastic surgeon who can demonstrate plenty of experience with tummy tuck surgery and who is available AFTER your surgery when you have questions. You'll benefit from involvement of your hematologist/oncologist in conjunction with your plastic surgeon.

Tad Grenga, MD, FACS
Norfolk Plastic Surgeon
5.0 out of 5 stars 11 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.