This educational writing reviews whether a tummy tuck can be done safely at the same time as a C-section. Is this a good idea or not? What are the pros and cons? Combining an abdominoplasty and C-section is not a wise choice, and the reasons will be reviewed in detail. By reading this summary, the reader will have a better understanding of why this is the case and also the surgical procedure and risks. It was written for a patient in Bryn Mawr, PA.
An abdominoplasty is a surgical procedure to make the abdomen or stomach flatter, tighter, smaller, and more attractive. It removes loose skin, fat, and tightens muscles. Pregnancy and having babies is one of the main reasons that a woman needs a tummy tuck. The pregnancy stretches out the skin and weakens muscles. After delivery, woman can have stretch marks, loose skin, and excess fat. Diet and exercise are recommended and can help. But this only works so much. Many woman are left with the “pouch” or “baby tire” that can’t be exercised off. The tummy tuck is the answer. This operation works with a high degree of success. Most woman will get high satisfaction with the surgery, and many will have the stomach they only dreamed about. Sometimes a woman is having a scheduled C-section and she knows she wants a tummy tuck. This leads to the question about doing both procedures at the same time. This is called combined or concomitant operations.
First, I will review the advantages of combining the procedures, and then I will review the disadvantages. The advantages to an abdominoplasty and a C-section combined can mainly be summarized as having one larger operation versus two separate operations. One operation means only a single recovery period. Also a single operation means only one anesthesia expense, so lower overall expenses. To review, the advantages are one recovery period and less money. This is enticing and sounds attractive to many people. It is normal to like these factors. However, the positives come at a substantial risk, that I will discuss now.
Combining the two operations leads to substantially increased risks! These problems include increased infection, bleeding, transfusions, and other medical risks. Also, the tummy tuck result will be worse with a less attractive or flat stomach. These are big problems that are extremely important. Safety should always be first. The combination of these procedures dramatically increases risks. You can think of it as “biting off more than you can chew!” Please see my educational writing on decreasing risks associated with an abdominoplasty by linking now.
Below I review some of the reasons why I do not recommend doing a tummy tuck combined with a C-section.
1- Bleeding
Combining the operations, leads to two surgical procedures performed at once. Pregnancy involves a state of body fluid shifts that increase the risk of bleeding. This is extremely rare with a tummy tuck alone. Transfusions are extremely rare with an abdominoplasty. But combine the procedures and risks go dramatically up to unacceptable levels, in my opinion. They can be completely avoided by not doing them together. Remember, risks are low with both procedures. It is the combination of the procedures that increases the problems.
2- Infection
Infection risks are also much higher when combined. An abdominoplasty is an extremely clean operation with very low infection risks. C-sections are not as clean. Doing the procedures together involves getting two surgical teams together with the necessary increased risk of bacterial contamination. Two surgical teams are in the operating room, and sometimes it is three teams. (Plastic Surgery, Obstetric, and also Pediatric teams). This means that too many people, nurses, doctors, and hospital employees are running through your operating room. This type of “traffic” has been shown to increase infectious complications. When I do my operations, people that are not actively helping me are not allowed in the operative room. This keeps things cleaner and is safer.
Also, C-sections are done in hospitals, and hospitals are not as clean as many surgery centers. Hospitals have much higher rates of infections like MRSA, VRE, and other super-bacteria that are not typical pathogens for tummy tucks. When the procedures are done together, it’s always in a hospital. In my opinion, it is almost impossible to be as clean surgically.
3- Worse Results
Abdominoplasty results are worse with both done together. This means the stomach won’t be as flat or defined. The uterus is swollen and enlarged and tightening of the muscles can not be done as well or as safely. Some doctors would advise against any muscle tightening at this time. Fluid shifts with pregnancy and C-section lead to a change in tissue characteristics. This leads to the inability to remove as much loose skin. Skin removal is one of the biggest factors giving a flat result. The tummy tuck results are typically below average and with much greater disappointment by the woman. I have had many people who have been so disappointed that they had to do the tummy tuck all over again.
In summary, combining a tummy tuck and C-section might seem like a good idea. It can allow for a single recovery period and sometimes lower expenses. The risks, however, include higher bleeding, transfusions, infections, and other complications! Results will not be as good because of swelling and tissue changes. Worse results will lead to more disappointment. If you want the best and flattest stomach, the operations should not be combined.
I never recommend combining these operations and strongly advise against it. In my experience, patients who have combined the operations are much less happy and often need corrective surgery. Please come in for a consultation, and I can review your situation in detail with you.
