Tummy tuck - Can plastic surgery fix my torn stomach muscles and umbilical hernia?
I have had 5 kids and I have an umbilical hernia and my stomach muscles are split down the middle. There is a two inch separation. I have some exess fat but not much. I weigh 118 lbs and I am not overweight, but I want my stomach fixed.
I went to a plastic surgeon and he sent me away saying " you don't have enough extra skin for a tummy tuck, and you need to talk to a general surgeon about the hernia and muscle split."
Does that sound right to you plastic surgeons? Is that a standard response in this type of situation or should I get a second opinion?
Answers (4)
A plastic surgeon who is also a general surgeon is what you need
What you have can be best repaired by a surgeon who is Board Certified in Surgery and also is Board Certified in Plastic Surgery. Wearing these 2 hats will enable the surgeon to best improve the aesthetics of your abdomen as well as repairing your hernia and tightening your rectus diastasis (the split between your rectus muscles). In fact, just last week, I repaired an abdomen and did a tummy tuck on a patient who is almost identical to what you describe.
If there are no surgeons who qualify with this degree of training in Idaho, there are several who do so in Washington state.
Unless there is something else going on, you should get a tummy tuck.
After 5 children and having a rectus diastasis, I'd be very surprised if your skin has not stretched out enough to warrant an abdominoplasty. As a matter of fact, I'd be very impressed if you did not show overt laxity. You should really get another opinion by a board certified plastic surgeon who does abdominoplasty surgery.
A tummy tuck is not a tummy tuck is not a tummy tuck. While patients and surgeons alike use the term tummy tuck or abdominoplasty to indicate a particular procedure, in reality, it is best to analyze the anatomy of individual patients, discuss the desired results, and then design an operation to fit your particular needs. What you call the procedure is less important. I have found that patients respond variably to pregnancy. Some have abdomens that are destroyed by one pregnancy and other, with five prenancies, look virtually normal. You may have more muscle issues than skin and it would be important to separate out the anatomical components of your concerns. You may be a good candidate for a muscle repair to correct the diastasis recti and hernia without any skin excision or perhaps a so-called limited "mini" tuck or "modified" abdominoplasty.
What you likely have is what is called a "rectus diastasis", where the two rectus muscles of your abdomen (the muscles that make a "six pack") have widened and moved away from the midline of your body. This is quite common after pregnancy, and certainly after 5 pregnancies. Having an umbilical hernia as well is very common and we often fix them during tummy tucks.
Without having examined you personally, my guess is that while you may not have a lot of extra skin, you probably have some, and you almost certainly have significant laxity of your abdominal wall muscles. This means that you would likely be a good candidate for a tummy tuck.
When I examine a woman's abdomen, I'm looking at a few things:
laxity of the abdominal wall muscles
amount of excess skin
presence of excess fat
location and shape of the belly button
presence of any old scars (for example from a C-section or from abdominal surgery)
In many cases, the majority of the work and attention during a tummy tuck procedure has to do with the tightening of the abdominal muscles to help flatten the abdomen, improve its contour, and reconstruct those six pack muscles. Removal of excess skin is also important, but it's not the only issue that is corrected.
Bottom line: Just because you don't have a lot of extra skin doesn't mean you can't have a tummy tuck. I would recommend seeking a second opinion from a Board Certified Plastic Surgeon.
Best of luck! Dr. S
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