I had ER surgery in 2003 and the Dr. made his incision on upper right side. I was told that because of the incision, I wouldn’t be a candidate for a tummy tuck, is this true? What r my options?
Hello Ms. Fyne. Thank you for your question. Although there are some limitations due to the gallbladder surgery incision a tummy tuck is possible afterward and a procedure I have successfully performed in the past on similar patients. It is important to get an in-person evaluation with a board certified plastic surgeon to discuss your options. Best of luck!
Dr. Katerina Gallus, MD FACS
Your situation is not an absolute. You would need to be seen and evaluated. There are many factors that would figure into a decision so I would recommend a consultation with a board certified plastic surgeon.
Best of luck
Jack Peterson, MD FACS
It is a relative contraindication if you are using traditional techniques that undermine to the level of the costal (rib) margins.
If you use the Lockwood technique that undermines only the central part of the abdomen it is not a contraindication because the skin retains a better vascular supply.
To understand how that is done you could look at videos I have posted online at my Instagram account (Cosmetisurg) that show the actual surgical dissection used and how it preserves vascular supply.
I have performed abdominoplasties on patients with previous gallbladder incisions. I will say that there is a slight increased risk of potential complications with it. I have not had a problem with wound healing.
You ask a great question. An incision for an open gallbladder removal is called a "subcostal" incision. In terms of blood supply, whenever a scar is made (from an incision), we as Plastic Surgeons have to take into account whether we think there is good blood flow to the skin above and below the scar because it sort of acts as a potential "road block". I can speak from personal experience that I have carefully performed full tummy tucks with upper abdominal liposuction on patients with your scar and it has healed perfectly without any issues. That being said, I think most Plastic Surgeons would agree that there is a slightly increased risk of wound healing issues in that area. Make sure you consult with a board certified Plastic Surgeon who can weigh in on your situation with a good examination. Best wishes!
i have done some with the same surgery previuosly without any problem
Dear Ms Fyne,
Hello and thank you for your excellent question. The incision you have had (called a Kocher incision) is NOT a contraindication for a tummy tuck, if the tummy tuck is performed properly. It is best to answer your question during a face-to-face evaluation, when you can discuss your goals and expectations for the procedure, and you can have a physical examination to evaluate for that procedure. I recommend that you find a board-certified, or board-eligible plastic surgeon with whom you are comfortable. Be sure to have all of your questions answered during a face-to-face meeting with your surgeon, and review before and after pictures of similar patients whom have had this procedure. If you have any questions, call our office for assistance. Good luck!
The advice you received is the traditional understanding based on how tummy tucks used to be performed, where undermining was carried out all the way up to the rib cage. The scar would compromise the blood supply, and could threaten the healing of the abdominal skin. Newer techniques preserve the central abdominal blood supply, and make it so the you can likely have the surgery with a very good chance of a great result. Good luck!
Yes, a tummy tuck can still be done but with some modification. Either a lipoabdominoplasty or a reverse abdominoplasty are possible options. An in person evaluation is the best way to find out.
I agree with Dr. Wallach. You can expect the gall bladder scar to wind up in the right lower quadrant of your abdomen, where it will look like a very large appendectomy scar and may occasion some comments, so be prepared.
Thanks for a good question. Actually you need meticulous evaluation because still there are alot ot alternations for classical abdominoplasty with undemining to costal cart.
But this depend are you have diastasis of recti or not and ifyour abd wall laxity isin inferior abdomen only
If not TULUA technique with wide liposuction will be good alternation
The right subcostal incision may reduce blood supply to the abdominal skin but it does not mean that you are not a candidate for abdominoplasty. I have done it on previous patients and have not had any problems. Your surgeon will need to be more cautious and conservative during the the procedure and vigilante for ischemia after surgery. Good luck.