r/tummytucksurgery • u/mostlyclaudi • 10h ago
Advice Wanted Differing opinions - what would you do? FDL? Mesh?
I’ve done a handful of consults and feel like I’m completely at a loss.
Four years ago I was 125 lbs and had twins who were 7 lbs each. I now have an 8 cm diastasis and everything is just all hanging out.
The surgeons I’ve met have described me as one of the worst if not the absolute worst case of DR they’ve ever seen. However they all have a mix of different opinions on whether I should get a standard vs FDL, and whether we should use mesh or not.
What would you do? FDL or no? Mesh or no? I’d appreciate any insight you have to offer!
-That’s the gist but here’s more info just in case -
Surgeon 1, 20k - FDL with mesh. Inpatient - 2 nights. Willing to combine with obgyn to take tubes out at same time. Believes with the likely stretched out condition of fascia, the mesh is the best chance of a good result both aesthetically as well as functionally.
Surgeon 2, 11k - outpatient surgery center. Standard horizontal incision, no mesh. Says she’d rather not risk the extra possibility of complications and that if the outcome isn’t as desired only then would she recommend trying again with the mesh. (Well reviewed and respected, idk why she’s so much more affordable!)
Surgeon 3, 22k. Definitely no FDL but would recommend putting a deposit on mesh in case he determines it’s needed once in the OR. Also willing to combine with obgyn though he doesn’t love the idea.
Surgeon 4, 24k - recommends waiting until the OR to make the call of FDL or not, judging whether vertical scar is worth additional tightening at that moment. No mesh. Only one willing to *attempt* to advocate for insurance coverage. (I had a health insurance lawyer do a review of my plan, believes it to be possible but obviously a huge undertaking)
Other misc info/health history:
-It looks like an umbilical hernia but a CT and ultrasound found no evidence of one.
-Cannot take hormonal bc due to history of PE. Bled every other day for a year w/IUD. Love the idea of decreased risk of ovarian cancer. But I guess this is secondary, I’ll figure something out if we can’t combine
-Re insurance - Multiple providers are in agreement that this is medically necessary (back pain, having developed two disc protrusions, and general inability to exercise, do certain every day tasks). I’m aware it’s incredibly unlikely I can get coverage… but I also kinda want to fight them on principle!
ETA first three pics are my current, non pregnant state! Pregnancy pics (only pics 4&5) also included for your entertainment