Is it possible that abdominoplasty can help support proplapse?

Submitted by Zephir on March 23, 2011 - 1:25pm
Body: 

Hi Ladies!

I am so, so excited to join your forum! I am inspired by Christine Kent's vast wisdom and knowledge regarding prolapse.

I am a newbie...for about 6 months, I have noticed what I believe to be a urethra prolapse and I am getting a urologist appontment for April 6th. I do not wish to have a surgery and I will be trying my best to avoid that by purchasing Christine's "First Aid for Prolapse" videos.

However, I must explain the abdominaoplasty question. -I have had 4 children in the span of 5 years, with my last child now 10 years old. I have tried for years to lose weight, but I am a type II diabetic (mild), and therefore, weight is very hard to budge. I am now presently following the only program that has merit for me personally and that I've had success on in the past: low carbohydrate counting (which has the twofolod benefit of weight loss and more importantly, insulin regulation).

Having said that, no amount of healthy eating or exercise is going to cure a sagging "panni" of skin post-pregnancy and post-surgery; this needs to be corrected via the same way it got there; surgery.

Because abdominoplasty is not covered here in Canada (and believe me, in certain cases, I truly believe it should be for medical reasons), I am going to be getting one in Sept./October when I have enough funds saved.

I cannot help but wonder, after all of these years carrying around a heavy front apron of skin above an already twice operated upon scar, if abdominoplasty with muscle repair (the one I'll be getting) can also help to keep the pelvic organs in place.

Does anyone have experience with this? I wonder if Christine will see this post and I cannot help but wonder about her thoughts on this one. Hey, if there's noone out there that has had this done before, maybe I'll be the pilot-case in this regard and I can certainly post my afterthoughts, post surgery!

I did not go into my symptoms regarding the urtethral issue that I'm having, only because I wanted to keep this post on-topic with my question and when I saw "Bodywork", I figured that my question could be placed here without too much confusion. However, if anyone thinks it should have been placed somewhere else on the site and can tell me how to re-post, I would gladly do so!

I sincerely appreciate all of the posts regarding bladder/urtheral proplapse and all other prolapses. Us women need to stick together and feel free to discuss this with each other.

Huge hugs to all of you and believe me, many of your symptoms, I live with everyday now for the past 6 months with regard to frequent urination, etc.

Blessings,

Mary/a.k.a. Zephir

louiseds

March 23, 2011 - 9:57pm

Hi Mary

Your question doesn't really fit the Post-surgery Forum. It is fine here.

I can see that you really want to move on to the next stage in your life and that you feel that your pannus and the scars on your belly need 'tidying up'.

Fascia, the soft tissue that sits between, lubricates and supports all your body's organs and structures goes from the top of your head to the tips of your fingers and toes in one continuous three dimensional web which is subdivided and recombines along the way, through the different compartments of your body. Your pelvic organs are surrounded by the endopelvic fascia inside your belly, while your skin is on the outside of your muscles, which are outside your belly. It is the stretching and damage to the endopelvic fascia which allows the pelvic organs to prolapse, just the same as it is the stretching of the fascia that runs through your belly fat and holds your skin to your abdominal wall that has come away and left a pannus.

From my reading muscle reduction is excision of surplus stretched ligament tissue from the midline (up and down), where the rectus abdominus muscles have separated (diastasis), so the muscles themselves are not touched during the surgery, which is good. You need your rectus abdominus muscles to be able to stretch to their full length so you can lift your chest high in WW posture. However, the bit of midline ligament that they will be cutting away is joined in to the body's fascia system.

I cannot see a mechanism by which these surgical procedures could possibly help your prolapses, but I can see the possibility of further damaging your body's fascia during the 'muscle' repair, when the midline is excised. I am not a doctor. You need to ask your surgeon about this. If he says that it will all be joined up again you can decide whether or not to believe him. The inability of fascia to repair itself or to be surgically repaired with any great success is the very reason why women who have episiotomy or birth tears often end up with POP. The midline may be a different case. Ask the surgeon.

How much do you know about the procedures you are planning to have? Does your doctor have a website? Also have a look at some other medical clinic websites for different descriptions. Many sites about panniculectomy only give the sales pitch from the doctor's perspective.

Have a look at this page, http://boardreader.com/tp/Panniculectomy.html . This is a Web search of pages that list panniculectomy in forum discussions. The links on this page will take you to Forum discussions on this topic, so you are getting the patient perspective.

One of the problems I did pick up about panniculectomy is that women often find that their weight comes back after the surgery, being added to other parts of their body rather than to the belly. Their bodies become quite distorted, which is a further trigger to hatred of their body and can be very stressful, triggering further weight gain and the need for further surgery.

I fear that I see the same story with these plastic surgery procedures as I see with POP repair procedures. They all interfere with the body's natural structures, distort the tissues and often enough cause further problems. When further problems occur the woman no longer has a complete set of supports for further repair work, eg the abdominal skin is torn away from the body right up to the ribcage in some procedures and never regains those connections. It gets worse with every op. Like with POP repairs many women regret having the procedure, or at the very least recognise that it does cause further problems which sound to me worse than the initial pannus, and they certainly are letting the world know about their despair, especially women who are doing their research before having the same procedure.

I am so in awe of people who tackle weight gain issues and their side effects by diet and lifestyle methods. It really takes guts and you seem to have had some success. I suggest that you continue on this path until you reach a healthy weight. This is what will reduce your insulin dependence, not the surgery, thought the surgery will be infinititely more painful and the recovery probably just as long! You will still *need* to have a healthy diet and lifestyle, regardless of whether or not you have this surgery.

The scars on your belly and the pannus you have are simply features of your body, not landmarks for others (or you!) to admire or judge.

*They are a part of you and they demonstrate some of the story of your life*.

They could be seen as your childbearing trophies. Cutting them off may change your belly and your body, but it might not be for the better of your body or your wellbeing in the long term.

If throwing out all the trophies makes the trophy cabinet fall off the wall and smash, wouldn't it be wiser to leave the trophies there as mementos and prevent having to clean up the mess on the floor and have the wall repaired and the room repainted to hide the replastering????

Louise

MeMyselfAndI

March 24, 2011 - 2:21am

I know that fiddling with the abdominal muscles can make prolapse worse.... Maybe not forever - You have to work with your body, my belly muscles were fiddled with in a Hernia repair and it DID make my prolapse worse for a while. I made sure my posture was right, and in a while it was OK again. It takes work and you hafta be ready for it to be worse......

I also believe that no abdominoplasty should be done until you are very close to goal - as if you shrink again after - You would have to go through it again and you get better results when you are at or very close to goal weight. And you would want your weight to be under control. I do not know of anybody who had had the panni done alone, though I know of a few people who have had all types of abdominoplasty from the simple under panty line one to the full abdominoplasty.

If you are in the posture - removing the sagging panni shouldn't be a problem, depending on it's size I guess. It should help any back pains from it though.

You really need to check out your surgeon - Make sure she/he understands your wants and needs, one you feel will aid your journey, NOT just on the price you can afford... Remember this is yoru future that is in his hands... And your life. And I guess he/she needs to specialise in post weight loss patients as they have more skin to be removed, which can both help and hinder the doctor. More skin meaning it can be moved easier, but also that would hold more blood vessels within it.

If you have the panni only removed - It does look weird. If you gain weight back after that it would look distorted. If you have the inverted T then gaining weight back looks more natural from what I can see in pics....

I really believe that 'messing' with the belly muscles can cause problems with Prolapse but you and only you can weight up your pros and cons. And only YOU can do that. But I would say that you really want to look after yourself, and get control of the weight - There are many websites that talk about this kind of thing (make me heal and lapbandtalk sites all talk about this kinda thing and women who have had this done are there so you could ask all the questions you need to BEFORE you take any further steps with doctors etc)

Good luck with whatever you do - Keep us posted :-)

Zephir

March 24, 2011 - 8:36am

Thank you so, so much! I sincerely appreciate your post, as you truly reflected inward on how your hernia surgery had affected your prolapse and how it did get better with work! The message that you finally did heal is a big one...

I too, believe that tummy tuck repair should not be considered until one is at or near their ideal weight. That is why I had waited years to even consider it (and financially as well). I am hoping that by Sept./Oct. with all of the body work that I am doing, that my at least 20 of my 40 excess pounds will be gone. -I think a 20 lb. loss on my part is quite significiant in terms of mobility after surgery, recovery, etc...

I'm going to have the muscles repaired as well. -A full abdominoplasty, not just the panni. I know I discussed the panni mostly yesterday, but only because I was thinking about that added weight hanging right over the bladder area, which does put pressure on this region. I do wonder if less pressure there will help and only through removing it, can I know this. :)) I can certainly speak to how it does hinder me now and create extra weight to carry in this area and sore back muslces.

I sincerely appreciate your openmindedness about it being "my life", Miss Me Myself & I! :) ...What a cute name! :). Sometimes, the full meaning and impact to a person's thoughts can not come through without facial, in-person conversation. I may have appeared "frivolous" in how I conveyed wanting the tuck, but honestly, it is more for my health that I want it, than for cosmetic purposes and I realize in my case, taking "any" weight off, both through my own efforts and that of my surgeon's efforts, will lift quite literally, a heavy burden from my hips, lower back and front stomach. Also the muscle repair (from ab. seperation) will not have this region as lax and hanging. Having said that, the surgeon will also not cut and sew me so tight that I can't raise my arms above my head. This surgeon is not into doing this to women (i.e. over tightening them and making them appear more "toned"). He is into ab. repair for the health of the individual. I think this is "the" most important reason to seek other ways of viewing tummy tuck/abdominoplasty, for the health of the individual. For so long, our healthcare systems just wanted to believe that it is purely cosmetic and then aptly not cover it, when cosmetic is to me, a "spin-off" effect for the probable cause of many other medical issues.

Have a super day and thank you so, so much again! :)))

MeMyselfAndI

March 24, 2011 - 9:13am

To be honest I do not think the removing of just the panni will in any way cure the prolapse - It will just be different. The muscle-messing is what I believe will be the thing you will notice most - If you pull your belly in as long as you can - That is how ity will be they take both sides of the 'gap' and pull the muscles together and use a permanent stitch to hold them there. - Though the muscle ccan stretch again and also - It can herniate and stuff - This is somethign the belly can always do... But you can get a hernia just by sneezing...

I reckon the muscle repair is the most worrysome bit... That is what would hurt you at first, and maybe 3-4 weeks after you would get more used to it - Someone I know who had the muscle repair said it felt very different with the muscles being tight again.

I do not believe it is a frivolous decision and I am sure you have noticed in your weight loss how this skin will only shrink so much.... I hope your Dr has told you that at about 7weeks post op you moisturise and massage the scars to soften them and help them to heal. This is IMPERITIVE to your healing - It helps the skin to heal better (E45 or Diprobase is good for this)

I do believe that if you keep your expectations within check then you won't expect miracles. If your surgeon is good at his job he will know what he wants to see as an outcome and he will take your needs and wants into account with that also. Depending on your age the skin loses elasticity and that obviously affects the outcome of all surgeries.

Personally I would wait it out til I was less than 10lb from goal - But that is for you and your doctor to talk through.

I do know how having alot of excess weight/skin feels. I know how this can emotionally be so confidence draining. I know how you feel when you lose a ton of weight but then you have to face the skin that you know will never just dissapear.

I believe if you have found the right doctor for you, and your expectations are in check, and you never expect to look 21 again (lol) you should do very well.

BUT - I will say that after my hernia surgery I did not have in place what I needed - Shopping all done - The stuff I needed around me - And people to help. If you get a list and make this list as if you are unable to go out for a month. Everything you would need to do or get done is on this list. Then you can just relax and heal without worrying about forgetting things - If you start your list now it gives you a focus and you won't have forgotton anything.

I wish you luck and hope you can tell me how it went for you afterwards...

You can email me through this site if you like :-)

Sue

Zephir

March 24, 2011 - 10:39am

Oh hi Louise!
A huge thank you and hug to you for all of the time you took in addressing my question. –Didn’t I just go and thank you on another post I just wrote about your caring answer to a question from “Mermaid”...my concerns were connected to Mermaids and so that’s why it’s there (please go ahead & look whenever you can!). And I smiled when I saw that my ques. was “good to go” where I put it. I think someone will eventually ball me out for where I put things, b/c it’s not my best skill in the world. Haha!
It’s funny Louise, because quite truthfully, I don’t at all care/mind the scar on my tummy and if anything, it will not tidy the scar up, but make a much bigger scar! :) However, there is a new way to view this bigger scar and here’s my take: having children definately changes a female body, from the inside-out and hey, if it can be detected in my insides-on my pelvic bones, as it can, then my philosophy is that any outside markers are par for the course!  In this regard, scars don’t bother me whatsoever.
The look of the panni in and of itself is not the reason why I am getting an abdominoplasty. –I wish to take the added weight that I cannot lose. Pannis never can be lost-they can reduce in weight, which mine has already- and as further weight comes off, it will droop down further, causing more pressure to the frontal regions of the body, ie. where the bladder is located, not to mention the pressure of the mons pubis, and all other internal organs, and hip bones and legs which take the brunt. I have fibromyalgia and Chronic Myofascial Pain Syndrom (CMPS) which my fibro. Specialist agrees that the disproportionate weight due to that muscle being cut already, “does me no favors” and he believes may even benefit me. (He does not know for certain as he did not have prior fibro/CMPS patients who had reported anything of this nature to him).
I sincerely appreciate your knowledge and wisdom, Louise. You are so right, when that fascia is damaged, it creates syndromes of its own and truly, I do not think the body ever forgets such an intrusion. As a matter of fact, I realize that 4-14% of all c-section surgeries injure the bladder, not to mention the fascia tissue, due to the surgery itself. This would explain why so many of us are “here”, I suppose (fascia damage and then eventually, POP). This is not to say that we should keep on damaging our fascia tissue with further surgery. However, if we and our physicians feel that it can alleviate pressure to that area and possibly help ease pressure of internal organs, ligaments, bone, etc., then it is something my healthcare team deems as a corrective measure and possibly too, a preventative measure for further complications. –This is how I view muscle repair most especially due to previous c-sections.
For me, the ligament they will be cutting away no longer works and in some ways, having something that no longer functions properly, will be less of a burden/stress on the body. Having said that, as I was saying to “Me, Myself & I” in the post above, having a board qualified plastic surgeon who views abdominoplasty the way it should be viewed-as a way to better health-will not be pulling the skin so tautly that a person will not be able to raise their arms ever again... as in performing gentle WW exercise or any other gentle exercise. Through lymphatic massage, etc., this will come.
Again, it’s all about the measure. I have given it a lot of thought and prayer as well as medical consultation, but none of the specialists had patients who have actually had full tummy tuck (with muscle repair and of course, the panni removal) in order to speak to my question regarding POP and possible benefit. This would require a study.
Louise, I truly believe you are right; fascia will be damaged as it has been already (and ergo, why I believe is a contributing factor for having fibro. And chronic myofascial pain syndrome to begin with!). But as in all things in life, most especially in health issues (take chemo and cancer for example, or gall bladder disease and removal)...sometimes, we have to experience short term pain for long term gain. The panni I have is a direct result of being cut in the first place and I feel that the only way to repair that muscle, etc. is to have the surgery. Several doctors felt strongly that this excess skin is directly contributing to much of the pain in my hips/back/etc. My fibro specialist is well versed on the relationship b/w surgery and fibro/CMPS and feels strongly that this is why many women who have had c-sections end up with these ailments. Having said that, he also views this excess weight in the panni as something that now needs to be corrected which could be of possible benefit and therefore, I feel like what “Me, Myself & I” said; in that it will take some time to become stronger and heal. It takes work and I’ve been through this kind of work before.
I have researched and read a pretty good deal about the procedures over the years and that is why I am going ahead with it/them and through exploration on the topic, I have come to know the pros and the cons pretty well. I just wondered if anyone else on this site had any experience with female issues such as POP after having had abdominoplasty.
My issue is not so much about weight gain (as I do not usually gain weight), as it is muscle repair of a particular area of the body that carries a disproportionate amount of weight that contributes to other problems (i.e. such as back/hip pain). I have seen individuals maintain their body fat percentage quite easily with tummy tuck (and still others who thought it was a “free ride” and proceeded to pack the pounds on!) and some studies indicate that the extra fat, once removed, “may” help with insulin regulation, as the fat in the abdominal region is a symptom of a disregulated fat metabolism. It may not help with cholesterol, etc. (there are conflicting studies on this), but the miracle is that abdominoplasty does help insulin do its job more efficiently and therefore, weight gain should not be a spin-off of tummy tuck, but an aid in this manner. For this reason alone, healthcare needs to study the issue further and possibly offer coverage to pre and Type II diabetics (non-insulin dependent) as their own disregulated fat can be corrected in order to help regulate their insulin sensitity! -As you probably know, many diabetics can and do achieve and maintain their weight, but most do not and can have some success...but may need further assistance... and a disordered fat metabolism is one of the reasons why.
Dear Louise, I do hope you do not perceive this letter as a debate or something, because as I sat here sipping my tea at the keyboard, I was wishing to have this tea with you and share a smile and laugh, because if anything, I hope you see that I truly value my experiences with my big belly...and in some ways, I will miss it...but if that big belly is literally hurting me (which it is) even after my weight loss, then sometimes, you just gotta let go of things that hurt you.
Do you remember that old expression, “If it ain’t broken, don’t fix it?” The problem is, this belly is broken from 2 prior surgeries and needs to be fixed (the muscle seperation, and doctors advice even to get it fixed to alleviate the hip/back/etc.)...or a broken trophy case that is ready to tip the barrel of trophies over! LOL! I will put it to you the way I have experienced it, so that you will understand it/me better...
If we had a leaky faucet in our kitchen sink, yes indeed, it is part of our life story...but only part...if we wish to fix it, as most of us would want to, then we should do so. -It does not take away any of the memories of the dribbling water, but a fixed faucet is a fixed faucet in the end. This faucet is no longer leaking and dripping, wasting precious energy and corroding the pipes while making that high pitched noise (i.e. think the “ouchies” in pain). To repair this leaky faucet may “hurt” for a time; as the wrench tightens its grip around washers and taps...but in the end, you have a kitchen sink that works-the water runs more smoothly down the drain and the corroding ceases...Heck, as to my initial question, of tummy tuck helping with POP- may not help with prolaspe as I don’t think anyone thus far on this site has experienced, but it will in fact help in relieving pressure off of my skeletal frame and muscles . And as for my trophies from childbearing, I carry these in my heart, not in my panni or scars.

Most sincerely,
Mary/a.ka. "Zephir"

alemama

March 24, 2011 - 12:33pm

It won't help and in fact I can't see how the extra weight from the skin is contributing to the prolapse issues you are experiencing. Also the extra weight from the skin is not causing the back pain you are having.
Weakness is the issue.
I would think the type of surgery you describe would be the worst thing you could do to your body at this time.
Surgery will not make you stronger.
Zephir, you can get stronger. You can work to heal your body, your prolapse. You can reverse your diabetes. You can do it! So many before you have done so. Look to them. It's work. Hard hard work. But it's work you can do.

granolamom

March 24, 2011 - 5:57pm

just wanted to throw my thoughts into the mix...
curious about the term 'muscle repair'. it comes up often here, in various contexts. afaik, when a surgeon attempts to repair muscle, he's basically stitching it together (with or without slicing it first). this will never approximate normal muscle tissue. it leaves a scar where the muscle fibers are stitched. and scar tissue is not as strong as muscle but more importantly it is not elastic. in cases where muscle is severely damaged this might be the best option, but just wanted to point out that it will not be 'good as new'. my opinion is that generally speaking, the less scar tissue, the better off you are. (and I'm not even talking about cases where scar tissue does unpredictable things like forming adhesions or excessively tightening, etc)

MeMyselfAndI

March 25, 2011 - 2:19am

That reminded me of something my first Hernia Doc said...

He said that the hernia could come back right beside itself after it was stitched...

As in the hole is stitched shut - You think all is well and the stomach wall then herniates again to the left or right or above or below (depending on which way round the hole is) itself...

Though I do not know if this is true with muscle repair so maybe I should shut up LOL

My Doc1 was right! He stitched up my hernia - And then it came back right beside itself and I had to go through a second hernia surgery for that... I pray it doesn't do it again!

As i said somewhere below - As we all do - You have to weigh up all pros and cons in your life and make your own decisions... :-)

louiseds

March 25, 2011 - 5:14am

Sure Mary. I can now see that you have done lots of research in coming to your decision. I wasn't trying to create a debate, just to put some points that I thought you may not have considered. I can see now that you have already been over that territory.

(((I wish you all the best))). I think MeMyselfandI makes valid points too.

Louise

Zephir

March 25, 2011 - 7:43pm

Thanks a million Sue! It is so comforting to be supported with your wisdom and experience. Much appreciated!

Zephir

March 26, 2011 - 5:42pm

It is not at this time that I am getting surgery. It is 6 months away and in that half year, I do plan to continue doing what I've been doing; eating healthfully.

I did not mean that I believe that the skin is contributing to the prolapse, but that the extra weight from the extra skin is indeed, heavy and my question was to those who have had abdominoplasty and the effect on their prolapse.

When you say, "It won't help", I deduce that you have had an abdominoplasty with muscle repair and obviously, you are speaking from your experience with it. I appreciate that, so thank you for your experience with this topic.

I am working to heal my body, but do understand that excess skin that hangs down in front, is not able to fix itself, no matter how much weight loss. It is "loose weight". My question to the forum was to those who have had abdominoplasty with muscle repair and their experience with POP after that. No more, no less. Hard work is what we do as women everyday. I'm no different in this regard. :) Thanks for your feedback.

Zephir

March 26, 2011 - 5:46pm

Dear Louise,

I sincerely appreciate your thoughtful voice to this discussion and yes, I do think that MeMyselfandI had made terrific points on this subject.

I can tell you are a gem and your thoughts on this issue were and are insightful for women everywhere to ponder at specific junctures in their own journeys.

Huge Hug to you Louise!!!

Mair/Zephi

alemama

March 26, 2011 - 7:07pm

I can reply if I like.
and I liked :)
Sorry not to be completely clear though and to confuse you unnecessarily. I have never had the type of surgery you describe.
I know what you mean when you ask for personal stories for sure. I came here a total wreck and it was the personal stories that uplifted me, gave me hope, and helped me realize I was not broken and in fact, things could get much much better.
Maybe if you search google for a group specific to the type of surgery you are seeking you would get more personal experience stories.
But I'll tell you what (even though you didn't ask) if the type of surgery you are planning helped prolapse in anyway whatsoever I promise you every surgeon from here to the ends of the earth would have women signing up for it.
I can also tell you from personal experience that diastasis recti can be corrected without surgery. There is a yoga breathing exercise called Nauli that will help heal the separation in the muscles. There are other techniques as well that help.
Look, I understand now that this issue is a touchy one- forgive me for not treading lightly. I enjoy discussing different surgical procedures, exercises, and lifestyle choices and how they can help or harm the body. Of course it's always your choice and I certainly wouldn't try to talk you out of the surgery or even ask you to confide your reasons for wanting to go through with it to begin with.

I think once you get into the posture and start the dvd exercises you will notice your back pain will feel much better. I'm 100% sure that I could sling even a 20lb weight off my lower abdomen and do just fine with it while in wholewoman posture. I'm glad that you have 6 months before you go forward with the surgery simply because you will have a chance to make Wholewoman techniques an automatic part of your life.

cuddles

June 24, 2014 - 5:30pm

Hi I am 49 and have five children. Last year I was diagnosed with a hernia in the left groin area. I am a week and a half out post op from having the hernia surgery (6/11/2914). In Jan.2014 I was diagnosed with MS and am currently having a relapse of symptoms. I am not on any medications other than vitamins.My first pregnancy was a C-section and they used the old incision for the hernia repair. I had a one week follow up appointment at the surgeons and I explained to him how I have been feeling since. I still have a lot of swelling. I also am feeling an achy heavy feeling in my lower back that travels around to the front where my incision is. I am also very numb in the area at least two or three inches around where my incisions is. My question is the surgeon said that he removed my round ligaments on that side. Could this be why I am feeling this way? Is there anything I can do to help this heal if I do not have the round ligaments? To my understanding he attached them at the closure for the hernia. Is there any hope for someone that does not have round ligaments. I am very concerned now that I have traded my hernia for another issue. I believe in the work you do and truly believe the body can heal itself. Thank you so much for all the work you do to provide women with the information and tools to heal themselves. It is so much more than the physical help. It is what it does to you mentally that really makes the difference when you know someone understands. :)

Surviving60

June 24, 2014 - 8:10pm

The above is a duplicate post. To comment on the above, please go here:
https://wholewoman.com/forum/node/6175