Total PE and possible tummy tuck at the same time

Hi sweetie,

I'm so sorry you are facing this surgery at all let alone a decision on the added procedure. 

I'm currently recovering from a TPE surgery and it is tough. I don't want to scare you but I think you need to know that the surgery is quite difficult and recovery is slow even without the added issue of type 1 diabetes. There's a steep learning curve with 2 new stomas but it becomes easy fairly quickly and you'll be surprised how quickly you adapt. The shock to the body from such a drastic surgery is the primary issue. 

My best guess about the tummy tuck is they are looking to give you a better (smoother and flatter) surface around your stomas. Folds, scars, and skin folds make it much more difficult to attach the ostomy bags and keep them on. My lower abdomen looks like the surface of the moon with bumps and craters everywhere. Fortunately my stomas were placed very high and avoided that mess. If they don't feel they can avoid your problem areas then they may think it is worthwhile to do an additional procedure.  I'm on another forum for ostomates and from the problems I've seen there, I would let them do the additional procedure.

Of course the final decision is yours but it might help to know what others think. I'm on another forum for ostomates and from the problems I've seen there, I would let them do the additional procedure. In my opinion, the surgery will be difficult anyway, you may as well get full benefit from it. You won't want to have to go back for a second surgery to fix the problems you may have with your stomas. 

Hi Lee75 

I had my TPE almost 5 years ago, but didn’t have the potential issue of a tummy tuck. That’s a phenomenal amount of weight you have lost, so I can understand why a tummy tuck has been mentioned for the saggy skin. 

I agree with Susan13 in that saggy skin can make things problematic with stomas. After my surgery I lost 3.5 stones, and everything changed in my tummy area which made it very difficult to get my bags to fit well without leaking. Things did settle down for me as I gained the weight back, but my weight loss made things awkward.

With losing such an incredible amount of weight, I think it would be sensible to give a lot of consideration to the tummy tuck to try and improve things right from the start, although I appreciate it would be very daunting to have to consider another procedure. 

As Susan has said, recovery is long and it can be difficult, but I’m sure your surgeons will outline exactly what will be involved in doing the extra procedure and how it might impact on recovery. My feeling is that I would want everything done at the same time if possible to make things better in the long run. I have numerous friends who have had the TPE and have had to have additional surgeries (though not specifically a tummy tuck) and it’s been harder to do this second time around. 

Sarah xx

Thanks Susan I appreciate you taking the time to respond. I figure that if it means I get a better outcome, and I'm on the operating table, then I may as well maximise the opportunity. The recovery is what is daunting me the most though. I'm not good at being poorly, and I'm realistic that I will be recovering for a long time and it won't be easy.

I hope that your recovery is going well 

Best wishes 

Leeanne

Hi Sarah

I'm on the same page as you and think that I'd rather get it done in 1 hit at the start rather than have issues. I'm having an examination under general anesthetic next Tuesday and they are going to be looking at whether they all agree that a tummy tuck is for the best. 

You've been so kind replying to all of my posts with my worries and questions so far. A big thank you. I have a feeling that we'll be chatting a lot more in 2025.

Happy new year 

Leeanne 

Hi Leanne

Please keep asking as many questions as you need to-it was hard for me to imagine what the whole surgery and recovery would be like, but I did meet a couple of ladies in person for lunch  before I had my op who had been through it and that helped. Especially because I could see how well they were doing. They told me it would take a year to recover and I wasn’t sure I believed them, but they were right! I turned a real corner 2 months after surgery when suddenly things started to get much better-my appetite was back and I could do more but it was a tough ride at the start. 

Susan and myself have been there, done it now so we will both try to help support you as much as we can. I hope the examination under anaesthetic goes smoothly, and before you know it the surgery date will be here. Put your faith and trust in your team. 

I hope that 2025 will be your year-with the cancer gone and your recovery going well.

Sarah xx

Hi Leeanne,

I am truly happy to share my experience and support you. I received a lot of support before my surgery and I want to repay that. Also, it makes me feel like my experience has value beyond just living thru it. It's a gift for me to be able to help. 

Please keep in touch. And Happy New Year! 

Hi Lee75,

I only had a urostomy (2 years ago on January 18th) but had lost 6 stones nearly 20 years before that so have lots of flab on my tummy. I wish they had given me a tummy tuck while they were doing the stoma as it was hard to get a good fit for the bag at the start, especially as my stoma is an innie. (So there is a dip down into the opening as well as mounds all around it.)

They do make convex bags which help and there are rings too that fit around the stoma - especially useful for innies like me. I have no idea why some stomas are level with skin like mine and others stick out, making it easier to avoid leaks. Maybe you could talk with the stoma nurse at your hospital who will have seen it all. 

My operation was less strenuous than yours and by 6 months on I had recovered well and the stoma bags were fine. By the way, my stoma nurse told me a stoma belt would give me confidence with keeping the bag on. I think that would help you too though you would need 1 for each bag maybe. Again something to ask the nurse. I find nurses know more about the practicalities than the surgeons.

Hope this helps

Latestart (70 when operated on and very active)

For a double ostomy, you my be able to do 2 belts. The positioning of my stomas in a direct line made that impossible.  I needed to custom order a belt with 2 holes. Hopefully your stoma nurse can help you with that when the time comes. 

I love my belt and it makes the bags feel more secure (quite possibly just in my head!)

My urostomy was originally skin level but is now slightly below. I use rings and a deep convex appliance. My colostomy sticks out better and that certainly helps. I think the surgeons try to get them to stick out a bit but positioning can shift while healing. 

Thank you for replying, thanks for the info. My stomach is so soft and bobbly that the more I have thought about it, the more I'm hoping that they will do the tummy tuck. Just like you've explained, weight loss makes for a tougher life with ostomies. I've had some samples sent by my stoma nurse, some have soft flat flanges, and some has firmer plastic ones that are convex, and sound like what you've described you use. It does feel daunting having 2 to deal with, so I appreciate any advice. Thanks 

I've been looking for info for life with 2 stomas and most I've seen are not in line. The urostomy is lower, so you've definitely given me food for thought about discussion the position with the surgeons on Tuesday. I'm having my GUA in prep for op on 21st. Thank you so much. Strangely, I'm not as anxious about the urostomy and I am about the colostomy. But I'm going to miss my bladder more. Is there any 1 of yours that is easier to manage or are they different in their own way? xx