Combining Tummy Tuck with Rib Removal Surgery

Q: Dr. Eppley, I am interested in a repeat full tummy tuck with mesh reinforcement in conjunction with rib removal of the lower 3 ribs. I had a full tummy tuck done a decade ago and at the time the doctor did say that it most likely would need to be repeated with mesh reinforcement given the how well he thought the plication sutures would hold. He was advocating the use of well anchored mesh to supply the long term results that the procedure should provide. I am 5’5” and the lower part of the rib cage does present lower in the torso minimizing any desired hourglass result. At the time the doctor did feel that I would be a good candidate for rib removal if the procedure were to repeated. Since that time this doctor has retired but your name has come up as an expert in these types of surgery.

A: Mesh reinforcement on a repeat tummy tuck can be done. The only question is what type of mesh. There are lots of option but they fundamentally come down to non-resorbable polymer ones vs. slowly resorbable polymer ones that get replaced by considerable scar tissues over several years. Each has their advantages and disadvantages. Rib removal can be done at the same time although that requires small incisions in the back from the prone position. Ribs #10 through # can only be removed from behind. Only the subcostal ribs #7 through #9 can be removed from the tummy tuck approach.

Dr. Barry Eppley

Indianapolis, Indiana