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I had abdominalplasty 5 years ago including liposuction of…

Hello, I had abdominalplasty 5...
Hello, I had abdominalplasty 5 years ago including liposuction of flanks and muscle repair. I have recently become disabled in pain. I've never felt right (always pain above my belly button..not severe, but certainly not comfortable, but it was always normalized by my surgeon. Immediately after surgery, I had a very bad cough (lasted weeks)...this caused extreme pain in muscle plication above my belly button area (and bulging). My surgeon insisted the Muscle Repair was fine. I have lived with this for all of this time, because my surgeon insisted there was nothing wrong...and you really don't know what 'normal' is after this surgery. This December, I did a lot of lifting, moving boxes, etc. and suddenly my entire muscle plication became extremely painful..especially the area above my belly button which was the area I mentioned was bulging The pain is when I bend, lift, laugh, cough, walk, or use that area of muscles.. I also began to have pain through my groin (tearing sensations, needles, icy hot, I can barely sit down.). This pain is on my lower abdomen down to my mons area. I had some of this before December, but it became exacerbated when the upper area started hurting. My MRI shows a failed muscle plication according to a different surgeon....all bloodwork and everything else is normal. I have also been told I may have trapped nerves in my groin. I'm unclear who to see to fix this or give me a concrete answer on what is going on. My original surgeon has been very dismissive, told me this had nothing to do with the surgery, and has blown me off. I do not feel comfortable having him try to fix a problem he doesn't even want to admit is there. I think I may need a specialist in nerve issues, but I don't know who to see. My life has come to an abrupt halt. I cannot do much of anything because of the pain. Thank you very much. Andrea
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Customer reply replied 1 month ago
I have been checked multiple times for hernia and have been to a hernia specialist. I do not have a hernia of any kind.
Answered in 5 hours by:
3/7/2018
Plastic Surgeon
Plastic Surgeon, Plastic Surgeon (MD)
Category: Plastic Surgery
Satisfied Customers: 954
Experience: 30 years experience; Board Certified in Plastic Surgery; Member American College of Surgeons;
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Thank you for your question. You need to see another board certified plastic surgeon for another opinion. Who told you that you may have a nerve “trapped in the groin”? It is probably not a plastic surgeon who told you this. I am available if you have more questions.
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Customer reply replied 1 month ago
I have seen four other board certified plastic surgeons besides my original. All said it was probably the failed muscle plication, but were surprised by the amount of pain... but said the imbalance could cause the pain. The third said he thought it was the muscle plication AND I was also describing nerve entrapment symptoms in my groin...i.e. burning, pins and needles, tearing sensations, hard to sit down....( Yes, he was a board certified plastic surgeon.). One said it could be reacting to the Ethibond braided sutures and we should take everything out, send to pathology, and just let my abdominal wall go back to its original state. You can see why I'm confused. The pain is very bad and I am unable to do much if anything.
If you are in that much pain, then you need to do something. If the pain is related to suture reaction, then you will get pain relief from removing those sutures. I do understand your confusio. You should think about having those sutures removed. The reaction that your body makes around the suture material is well documented.
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Customer reply replied 1 month ago
I need to do something for sure. I'm just not sure who is correct and their fixes differ. I sort of think I may have all three issues going on...1.Clearly a documented failed muscle plication on MRI. 2. My symptoms in my groin match what I have read about nerve issues. (I read a lot after the doctor mentioned it ) 3. Who knows about the sutures.. It's hard to find a doctor who can deal with all of these issues.
Do you think removing all the sutures (along with scar) and letting my abdominal muscles go back to their original position would be logical? (The pain is tremendous, so I don't care what I look like at this point). Would this likely kill two birds with one stone by resolving the possibility of suture reaction and the imbalanced muscle plication pain? Or am missing something?
You should have the sutures removed and depending on what the muscle looks like at the time of surgery, you may be able to have another plication with different suture material. As far as the nerves being involved, I would suggest a “wait and see” attitude on that.
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Customer reply replied 1 month ago
I'm very afraid to do another plication after this nightmare. If I don't do a plication , would my muscles just go back to their pre-surgery state (with removal of sutures and scar tissue)? I just need to find the best way to get my life back..the best odds.
Then only do the suture removal. Removing the sutures and the “bad” tissue around the sutures may alleviate most, if not all, of your pain. Your muscles without plication will heal just fine.
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Customer reply replied 1 month ago
Thank you very much. Bet you've never heard this one before !
I have seen sutures reactions and breakdown of the plication a number of times in my 35 years in plastic surgery practice. The nerve problem is probably related to scar tissue formation and this may all be related to the suture reaction. Hope you achieve relief.
Plastic Surgeon
Plastic Surgeon, Plastic Surgeon (MD)
Category: Plastic Surgery
Satisfied Customers: 954
Experience: 30 years experience; Board Certified in Plastic Surgery; Member American College of Surgeons;
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Customer reply replied 1 month ago
Do you think the plication could have become weak due to a suture reaction?
The strength of the plication was definitely affected by reaction to the sutures.
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Customer reply replied 1 month ago
Nothing showed in the MRI to suggest reaction to sutures (some "stranding") , but not sure it would show up very much?
If the infection is severe enough, it should show up on an MRI. Your pain may also be from the muscle tearing and the sutures were not able to prevent that.
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Customer reply replied 1 month ago
Should I insist the removed sutures are sent to pathology to check for infection.
Infection of the suture areas is evident on observation at surgery. Some of the sutures can be sent for pathology examination.
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Customer reply replied 1 month ago
Ok. Thank you. This is just awful and my doctor has not helped me. I appreciate your thoughts.
You are welcome
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