Botox injections for abdominal reconstruction

This post is about having botox injections for abdominal reconstruction due to hernias. I would like to start this by saying that I have no medical training and this post is just a patient’s view of going through this procedure. If you have any questions, then you should speak to your doctor.

Botox injections

After having my large intestine removed in 2013 due to Ulcerative Colitis and having an ileostomy formed, I developed hernias. I also had other major open surgeries including a jpouch formation and subsequent removal. I have had multiple hernias as a result of these surgeries, both parastomal hernias, incisional and currently a large problematic hernia in my abdominal wall.

I’m due to have surgery tomorrow to fix these issues with an abdominal wall reconstruction and as part of the preparation for this, I have had botox injections into the abdominal muscles.

When I was told I was having this done, there was very little information and when I have spoke to other doctors and nurses, they have had no idea about it! So I turned to Dr Google (which generally is a bad idea but can be useful!!) I found a talk by a doctor called Talar Tejirian at the International Hernia Collaboration Symposium held during the 2017 SAGES Annual Meeting in Houston, TX on Thursday, March 23, 2017 on why she uses botox for abdominal reconstructions. Just a warning that this link includes a video and images of open surgery so please don’t click on it if you could find this upsetting. The video was ok but aimed at surgeons. I couldn’t find anything patient friendly by the NHS or other people who have been through this. Hence my reason for this post.

I can only describe my own experience of this, and I have no idea if this is typical or not, so please do chat with your doctor if you have questions and let me remind you again that I am not a medical professional. Also I will be honest with how it felt and talk about the size of needles. I do this because I wish I could have read a patient’s experience beforehand. But if you are nervous and don’t like this sort of thing, then you probably should skip the rest of this post.

hernias and botox for abdominal reconstruction

The procedure

The appointment was for 4 weeks before my surgery date, the doctors told me this is because the Botox is at it’s most effective 4-6 weeks before the surgery. They use the botox to paralyse the abdominal muscles. They do this because when muscles are working, they contract, by paralysing them, it makes them long and loose. And so when they do the surgery, they are easier to manipulate and stretch to cover the hole where the hernia was.

I went into hospital after being told not to eat after midnight and just drink water till 6.30am. We went to the day surgery unit in the hospital and saw the surgical team and then I went down to theatre. It was a weird feeling being in the surgical theatre awake! I have had 8 surgeries for my illness and so been in a few theatres but always knocked out!

I was in a hospital gown and had to remove all my clothes and laid on a bed. Then the surgeon used an ultrasound to find the muscles. There wasn’t local anaesthetic either, so I was a little scared. He injected into the muscle with possible the largest needle I have ever seen!! It kind of looked like a joke needle!

I will be honest, it did hurt. It was a very odd feeling as I felt the needle break the skin and then push through into the muscle. It was a long needle, but also quite thick. I could feel an odd burning sensation as he pushed the botox into the muscle and then removed the needle.

I really had my fists clenched and was trying not to swear as he then repeated this three more times on my left side, before moving onto four injections on my right side. The injections were on the front of my abdomen. If you rest your hand on your stomach with your thumb by your belly button, then the injections were about in line with the little finger.

It took probably 15 minutes in total and once it was done, I walked back to the ward. I felt the effects almost immediately. The muscles relaxed and my hernias extended pretty quickly. Back on the ward, I had a cup of tea and a slice of toast and then was able to return home.

After the procedure

It’s now been four weeks since the injections. My surgeon told me to expect for it to significantly worsen the hernias. He said “you will be cursing my name for the next month!” and he is right! Every day it feels looser. My hernias are sticking right out and I can feel so much movement inside my abdomen. I have spent most of the last three weeks resting, either sitting or laying down as it is incredible painful to be stood up.

I am using the hernia vests and support garments that I already had, but have found I need to wear two or three to feel secure. But when I do this, it squashed my ileostomy bag and I have leaks. So it is a difficult balance.

I am taking strong painkillers every day and struggling to sleep through the night. It is very uncomfortable even when I am laid down in bed. I feel like I can feel every movement inside my belly. When I lay on my side, it feels like my insides fall to that side! Very weird feelings!

It worsened every day, it isn’t the most painful experience ever, but it is very very uncomfortable even when sitting or laying, and when I am up and about walking or standing, it does feel like all my insides are going to fall out.

I just hope that the benefits during surgery will make all this discomfort and inability to do anything for the past month all worth it.

My next surgery is tomorrow and I am just hoping that it will resolve all my issues and this is the last time I will need to be dealing with hernias and the complications around them. Fingers crossed and I will update after the op.

I would love to hear from anyone who has also had the botox injections for an abdominal reconstruction so do get in touch!

Sam xx

You knock me down, I get the f**k back up again

Hello you lovely people,

Firstly, apologies for not being about for a while, it has been a tough couple of months and I just. haven’t been in the right head space to blog. We moved house on the 13th December which was manic just before Christmas, I left my job at Scope and I got my surgery date, this was all just after us losing our dog Lola at the beginning of December which hit us all hard.

Surgery number 9

So surgery. Number nine. FFS! I can’t bloody believe it. I am just devastated and it has taken me some time to get my head around it. It feels so unfair that this is happening again. I have two parastomal hernias and also then on my left hand side, the muscles have completely given up the ghost. There is a huge hole and it has been incredibly painful and difficult to manage.

Earlier this month I had botox injections into my abdominal muscles. They do this to paralyse the muscles. When muscles work they contract, for this surgery, they want my muscles to be as long and loose as possible. This technique is something I hadn’t heard of before and I couldn’t find out too much about it online. I’ll do a separate blog post to explain it in more detail.

Sam Cleasby blogger

I have to admit that the idea of yet another surgery has hit me hard. I’m angry. It has taken a while for me to even say those words out loud. The feeling of sinking back into a bad place, it all just felt too much. I decided to leave my job as I just felt unable to carry on being in so much pain all the time. I felt useless and worthless and just like a burden.

The bully

It feels like there is a bully standing over me who keeps pushing me down into the dirt. And every time I brush myself off and get up, there he is, pushing me down again. I really started to doubt myself, to doubt my worth in the world. This journey I am on, I started in 2004 when I was diagnosed with Ulcerative Colitis. When I had my first surgery in September 2013, I genuinely believed it would be the one and only and that it would fix everything. How wrong I was.

Now, don’t get me wrong, when I had my large intestine removed and a stoma formed, it cured me of the years of diarrhea and bleeding that had marred my life. My ileostomy bag gave me back so much and I was and am still happy to have it. The fact is that without it, I probably wouldn’t be here. But I really wasn’t ready or prepared for another 7 years of pain, operations and hernias that have made it all difficult but in a different way.

But surgery number 9, are you fucking kidding me?

This is going to be a big operation, I have a specialist who has brought in a specialist! The botox is meant to help as they are putting in a lot of synthetic mesh. It is going to be several hours of surgery and I am scared. Im scared of even stepping through the doors of the hospital. Nevermind going through the operation itself. I am terrified of the pain and the long recovery. I’m scared of it all. I don’t feel brave. I feel overwhelmed.

Sam Cleasby disability blogger


I love the musical Hamilton, and there is a line in one of the songs by Hercules Mulligan; it says “Hercules Mulligan, I need no introduction, when you knock me down, I get the fuck back up again” I must have listened to the soundtrack hundreds of times, but this week, that line really got to me.

I just suddenly thought ‘oh my god, that’s me!’ I have been knocked down time and time again, but every time I get the fuck back up again.

It’s not easy living with chronic illness and these ongoing complications of muscle problems and multiple hernias have certainly knocked me down a lot. And honestly, there have been times when I was down in the dirt when I thought I couldn’t get back up. That I was done in and had no more fight in me.

But you know what? As I sit there bloodied and battered, battle worn and exhausted, I use that time to sit back and look around me. I stop. I take a breath. And I see my cheerleaders, my support system, my friends, my kids, my husband, my family. All the amazing people in my life who love me. That time when I am down and flat on my arse, I use it to wallow, to heal, to re-centre. Sometimes I feel sorry for myself and sometimes I cry. Sometimes I am angry at the amount of time I seem to find myself sat in the dust.

But you know what I do then?

I get the fuck back up again.

Sam xx