Author Topic: Abdominoplasty for obese woman with hx of hernias and abdominal surgeries?  (Read 6223 times)

Offline dianajune

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I am very obese and have a long history of a variety of medical problems.  My hx includes a borderline ovarian cancer for which I had an abdominal hysterectomy in '04, gallbladder removal in '05 (with a scope), and two emergency open surgeries for hernias - one in '09 for a strangulated hernia & bowel obstruction, and the most recent one was this past October for an incarcerated hernia.

The left side of my abdomen has always been a bit larger than the right, however, it's more so since last year's operation.   The surgeon said he believed the contents of my abdomen have shifted to the left, and my new primary care provider agrees.  Moreover, I was diagnosed with diastasis recti, and the surgeon told me it cannot be fixed.

I don't know if he said that because of my weight, or if it's because it's not in his area of expertise?  He's a general surgeon, not a plastic surgeon.

Could anyone tell me if an obese person can have a tummy tuck because their stomach looks horribly deformed?  I feel like a freak and am tired of getting stares from people.  Losing weight has been difficult for me because of my surgeries.  I've been told after the surgery in '09 and the one last year that it will take up to a year and a half to fully recover.  It's only been 10 months.

Btw, both hernias were on the left side of my abdomen, and the incisions from both hernia operations and the hysterectomy are vertical, alongside my belly button.  One cannot tell these incisions apart, they are so close together.

Please help!  I'm getting rather discouraged about this and don't want surgery again, but if it would correct this deformity it would go a long way towards my feeling better, physically and emotionally.  Thanks!

Offline DrBermant

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I am very obese and have a long history of a variety of medical problems.  My hx includes a borderline ovarian cancer for which I had an abdominal hysterectomy in '04, gallbladder removal in '05 (with a scope), and two emergency open surgeries for hernias - one in '09 for a strangulated hernia & bowel obstruction, and the most recent one was this past October for an incarcerated hernia.

The left side of my abdomen has always been a bit larger than the right, however, it's more so since last year's operation.   The surgeon said he believed the contents of my abdomen have shifted to the left, and my new primary care provider agrees.  Moreover, I was diagnosed with diastasis recti, and the surgeon told me it cannot be fixed.

I don't know if he said that because of my weight, or if it's because it's not in his area of expertise?  He's a general surgeon, not a plastic surgeon.

Could anyone tell me if an obese person can have a tummy tuck because their stomach looks horribly deformed?  I feel like a freak and am tired of getting stares from people.  Losing weight has been difficult for me because of my surgeries.  I've been told after the surgery in '09 and the one last year that it will take up to a year and a half to fully recover.  It's only been 10 months.

Btw, both hernias were on the left side of my abdomen, and the incisions from both hernia operations and the hysterectomy are vertical, alongside my belly button.  One cannot tell these incisions apart, they are so close together.

Please help!  I'm getting rather discouraged about this and don't want surgery again, but if it would correct this deformity it would go a long way towards my feeling better, physically and emotionally.  Thanks!

This should not be construed as medical advice. I am a retired Board Certified Plastic Surgeon.

Welcome to our forum and discussion group.

Living life with excess weight is for most, a horrible experience. There is strain on body structures to support the mass that can damage joints of the hips, knees, and ankles. Female as well as Male Body Fat Distribution tends to concentrate the fat in the central abdominal region and breast / chest regions in bands circling the body. The abdominal fat storage is the omentum, a structure wrapping over the intestine inside the abdominal wall. The contour deformity is bad. However, most of the contour problem is deep to the abdominal muscle wall structures. Tummy tucks work more superficially and also help to tighten a loosened previously stretched fascia muscle wall structure.

Fat collecting inside the abdominal wall stretches and strains this structure and can be a cause of the separating of the rectus muscles or a Diastasis Recti. Trying to Repair of Diastasis Recti (Photo During Surgery) with the pressure of the internal fat is usually an exercise in futility. The internal forces normally tear apart the attempted repair or stretch the abdominal wall to disrupt somewhere else.

That is why most tummy tuck surgery is for dealing with problems After Weight Loss, not before it. Plastic Surgery is not an alternative to losing weight. I have collected a number of discussions and tools on this post:

Weight Loss Forum - Plastic Surgery Not Alternative to Losing Weight.

Even Pannus Reduction Surgery is better and safer after weight loss, not before or during.

Have you been monitoring your BMI Calculation?. What is the result of the calculation? Morbidly obese individuals have very high risks for elective surgery is another factor to consider.

I really like the new weight loss motivational tools of the wireless Body Fat Analyzers and Scales. They are among the tools patients told me they found useful while working on their weight. Our Standard Pictures for Body Lift taken during weight loss can also help with motivation.

One of the methods I used to discuss with my patients who had problems exercising with their weight was to use one of the advantages of fat in water: it floats. This can take some of the load off the stressed joints during exercising. Water aerobics and exercising instruction and or therapy were options discussed. Check out Search Amazon for Water Exercising Gear to see some of the resistance devices that permits even walking submerged enough to take the stress off of limbs yet burn up calories.

Hope this helps,

Michael Bermant, MD
Retired Plastic Surgeon
Learn More About Tummy Tuck Abdominoplasty Surgery
Michael Bermant, MD
Retired Plastic Surgeon
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