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Would it be a risk and unsafe to have a tummy tuck 11 years after spinal fusion?

Q:

I would like to have a tummy tuck.  I had a spinal fusion 11 years ago which left me with a 12 inch scar up the left side of my chest.  At that time, the surgeon also removed a rib for a graft.   I saw a plastic surgeon recently to discuss my having a tummy tuck/mommy makeover.  He expressed concern over the scar and the risks performing the surgery because of the old scar and blood flow.  However, another surgeon said it would not be an issue.  Who is right???

A:

Both are correct. You should always be concerned when patients have scars because they alter circulation. There are ways to look at the circulation of the skin and fat of the abdomen and plan surgery. I use a cat scan to look at the blood vessels that provide the blood supply to this area to plan operations for breast cancer patients every week. The study cost will range and you have to find that out from the radiology provider and they have to understand what it being requested. One way to avoid this is to find a surgeon who performs DIEP flaps.

R.W. Whitfield, MD

A:

Without knowing exactly where the scar is, it is impossible to correctly advise you about the risks of a mommy makeover. If the scar runs along the course of the rib that was removed, then you should have little trouble with the surgery. That type of scar usually leaves the blood vessels just under the rib intact. The biggest problem may be in the breast lift if the scar impinges on the breast area. A good plastic surgeon with a significant background in other surgery should have no problem modifying his or her procedure to provide what you desire safely. There are, however, some physicians doing these procedures who do not have that background, so beware.

R.T. Buchanan, MD

A:

Hi Sarah,

The abnormal blood supply to your abdominal skin is an issue, but the surgeon was likely trying to convey that it would not prevent you from undergoing a tummy tuck. It would be reassuring if you did ask your surgeon about any concerns regarding the blood supply below the scar, but a CT scan is not required to provide you with good advice about your suitability for this surgery.

M.L. Kreidstein, MD

A:

Tummy Tuck After Spinal Fusion:

This needs to be prudently evaluated by both your Spine Surgeon and your Plastic Surgeon. If your spine fusion is stable and does not require significant long term flexation with your abdominoplasty and with approval of your spine surgeon, one can undergo an abdominoplasty procedure.

R.J. Rohrich, MD

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