I do loads of tummy tucks. For sure we know it helps with back pain. When your abdominal muscles are loose, your core is shot, so your back works overtime. And I have heard from some of my patients that it helped them not have those little urine leaks when they laugh too hard, cough, or go running. Given the little peeing improvement stories were all anecdotal, I have not advertised tummy tucks help you not have those pesky peeing issues.
And then I found this gem in my Plastic and Reconstructive Surgery Journal from March 2018.
“Abdominoplasty Improves Low Back Pain AND URINARY INCONTINENCE.” (I added the all caps there. :))
What?! I love science, and this was a good study. They did a multicenter (good), prospective (good) study, where they got preoperative and postoperative data (at 6 months) on over 200 patients.
- 214 patients from 9 centers,
- mean age 42.
- mean number of kids 2.5
- mean BMI 26 (ie. not fat)
- mean weight of skin and fat removed: 1222 grams
- mean liposuction (which we usually do to the flank, bra strap area, pubis) 795 g
- mean diastasis (the separation between the rectus muscles) 4.5cm
Findings?
Back pain?
- pre surgery: 21.6% (8.8% had no back pain)
- 6 weeks after? 8%
- 6 months after? 3.2%
Urinary incontinence?
- 6.5 pre surgery (27.5% had no issues)
- 6 weeks out? 1.6
- 6 months out? 1.6
These were all statistically significant differences. Pre surgery predictors of back pain were: BMI greater than 25 and umbilical hernia. Pre surgery predictors of incontinence were age older than 40 and vaginal deliveries.
Thoughts?
YAY!!!!!!!!!!! I tell many of my tummy tuck patients that abdominoplasties are really reconstructive surgeries. This isn’t just to make them feel better about doing cosmetic elective surgery. I do tons of tummy tucks. I get to see what you look like from the outside, and I can visualize what you look like on the inside, and then I take you to surgery and I get to see it. I take photos of my patient’s diastasis so they can see what was going on. I have taken a few videos for particularly blown out patients so they can see how their muscles weren’t close to touching.
After surgery their abdomens are flat. But I also see their postures improve without them thinking about it, because their core is better. Their back pain improves. And now I have a study to show my anecdotal stories about patients who say they no longer pee when they go for a long run is a real thing. Statistically significantly in fact.
Why did our generation get hit with this harder than our mom’s generation? I am not sure. My theories revolve around gaining more weight with pregnancy (our moms were told not to gain more than 10-15 pounds); we are healthier (no smoking and drinking for us while pregnant); and we are having babies later (my last one was just before I turned 40).
Regardless, I love when we *think* something is true, to study it and find out our science proves it is true.