Having a hysterectomy (removal of the uterus) and abdominoplasty (tummy tuck) together is possible but not always recommended. There are pros and cons to having both procedures simultaneously that women should consider carefully before deciding.
What is a hysterectomy?
A hysterectomy is a surgery to remove a woman’s uterus. There are three main types of hysterectomy:
- Partial hysterectomy – the uterus is removed but the cervix is left in place
- Total hysterectomy – the entire uterus and cervix are removed
- Radical hysterectomy – the uterus, cervix, and surrounding tissue are removed.
A hysterectomy may be recommended to treat various uterine conditions like fibroids, endometriosis, uterine prolapse, chronic pelvic pain, abnormal bleeding, or cancer. The ovaries may or may not be removed along with the uterus, depending on the individual situation.
What is a tummy tuck?
An abdominoplasty, or tummy tuck, is a cosmetic procedure to improve the appearance of the abdomen. During a tummy tuck:
- Excess skin and fat are removed from the middle and lower abdomen
- Separated or weakened abdominal muscles are tightened and repaired
- The remaining abdominal skin is smoothed and tightened
A tummy tuck is performed to tighten lax abdominal muscles and remove excess fat and skin after pregnancy, significant weight loss, or aging. It can help achieve a flatter, firmer abdominal profile.
Can they be performed together?
Yes, it is possible to have a hysterectomy and tummy tuck performed together in one surgery. Combining the procedures may be appealing as it allows completing two operations while only being under anesthesia once.
However, having a hysterectomy and abdominoplasty together is a major, complex surgery with heightened risks. It should only be considered if there are medical reasons requiring both procedures.
What are the potential benefits?
Potential benefits of having a hysterectomy and tummy tuck together include:
- One recovery period instead of two separate recoveries
- Lower costs of having one surgery instead of two
- Shorter overall surgical and anesthesia time
- Achieve desired results from both procedures at once
What are the potential risks and complications?
Having a hysterectomy and abdominoplasty together significantly increases the risks of surgery. Potential complications include:
- Higher risk of bleeding and blood clots
- Higher risk of infection
- Longer operation time under anesthesia
- Complications from anesthesia
- Damage to internal organs during surgery
- Poor wound healing
- Loss of skin flap blood supply
- Unsatisfactory cosmetic results
The combined procedures lead to a longer, more complex surgery. This places greater stress on the body and requires a longer recovery. Healing could be compromised compared to having the procedures separately.
What factors determine candidacy?
To be a candidate for combined hysterectomy and tummy tuck surgery, the following criteria is often assessed:
- Patient is generally healthy without major medical conditions
- Patient is non-smoker
- Patient is at a stable weight
- Patient has strong reason for needing both procedures
- Patient understands and accepts the increased risks
Women with significant health issues like heart disease, lung disease, or diabetes may not be good candidates. Being overweight, smoking, or having a weak immune system can seriously impact healing and increase surgical risks as well.
How is the surgery performed?
The hysterectomy portion of surgery is performed first, followed by the tummy tuck portion. The steps generally include:
- General anesthesia is administered
- The hysterectomy is performed through an incision in the abdomen or vaginally
- The uterus and possibly ovaries and cervix are removed
- The abdomen is cleansed and prepped for the tummy tuck
- An incision is made spanning the bikini line from hip to hip
- Excess fat is removed from the middle and lower abdomen
- Weakened abdominal muscles are repaired and tightened
- Excess skin is trimmed away
- The incision is closed with sutures, drains may be placed
Combining a hysterectomy and tummy tuck requires extensive surgical experience and skill. A board certified OB/GYN and plastic surgeon team may perform the surgery together.
What is the recovery like?
Recovering from simultaneous hysterectomy and abdominoplasty takes around 6 weeks with the following phases:
- Week 1: Bedrest with slow ambulation. Moderate pain managed with medication. Surgical drains are often still in place.
- Weeks 2-4: Gradual increase in activity and walking. Stop pain medication once able. Bruising and swelling continues to go down.
- Weeks 5-6: Stitches are removed. Can resume light exercise and normal daily tasks. Bruising and swelling subside.
Full healing takes around 3-6 months. Scars will continue to mature and fade over the first year. Complete recovery to full activity level can take up to one year.
What results can be expected?
Expected results following combined hysterectomy and tummy tuck depend on the details of each procedure but generally include:
- Removal of the uterus, possibly ovaries/cervix with hysterectomy
- A flatter, smoother abdominal profile from tummy tuck
- Improved abdominal muscle tone
- Reduced loose, overhanging skin
- A more defined waistline
- Scarring along the bikini incision line
Final results are not visible until swelling resolves and full healing occurs, which can take several months. Some discoloration and numbness around the incision site is common.
How much does simultaneous surgery cost?
The average cost of having a hysterectomy and tummy tuck performed together is typically between $15,000-$25,000. Costs depend on factors like:
| Surgeon’s fee | $5,000-$10,000 |
| Anesthesia fees | $1,000-$2,000 |
| Hospital or surgical facility costs | $7,000-$15,000 |
| Total | $15,000-$25,000 |
Combined surgery may have lower total fees compared to separate procedures. But the extent of surgery means costs on the higher end of the range.
Is it recommended to have both procedures together?
Having a hysterectomy and tummy tuck at the same time is possible but not recommended in most situations. The combined procedures are a major surgery with much higher risks of complications. Concerns include:
- Greatly extended operation and anesthesia time
- Higher chance of bleeding, infection, blood clots
- Potential damage to internal organs
- Compromised healing capacity
- Less than optimal cosmetic results
For non life-threatening conditions, it is typically advised to have a hysterectomy and tummy tuck done as separate surgeries spaced several months apart. This allows the body to recover properly and lowers surgical risks.
In what cases might combined surgery be appropriate?
There are limited situations where having a hysterectomy and abdominoplasty together may be appropriate, such as:
- Hysterectomy is required for cancer removal
- Prolapse of pelvic organs requires hysterectomy
- Large uterine fibroids causing abdominal protrusion
- Severe abdominal wall laxity prohibits doing hysterectomy alone
In these medically indicated cases, the benefits of performing both procedures in one surgery may outweigh the higher risks. This is something to thoroughly discuss with your OB/GYN and plastic surgeon.
Conclusion
Undergoing a hysterectomy and tummy tuck together is possible but typically not recommended. The combined procedures result in a very complex, high-risk surgery that could compromise the results and recovery from both operations. In most cases, it is best to have the procedures separately with a recovery period between them. However, for some women with certain medical conditions, simultaneous surgery may be warranted after carefully weighing benefits and risks with their doctor.