When you’re told you need surgery for uterine fibroids, one of your first questions might be: What kind of surgery—and what kind of scar—am I facing? Many patients assume that minimally invasive or robotic-assisted surgeries are always the best option. But if your fibroids are very large, numerous, or deeply embedded, these methods may not be safe or feasible.
When minimally invasive routes aren’t recommended, ESSE Care offers abdominal myomectomy through a transverse (bikini line) incision, which can be closed by a plastic surgeon (if the patient prefers) to prioritize low-impact incisions, aesthetic healing, and whole-body recovery.
Let’s explore what makes this option so transformative for the right patient.
Who Is Abdominal Myomectomy For?
This approach may be right for you if:
- You have a very large uterus due to uterine fibroids (sometimes extending to the liver edge).
- You wish to preserve your uterus while resolving fibroid symptoms.
- You’re interested in addressing loose skin, hernias, or diastasis at the same time.
- You’re not a candidate for robotic or laparoscopic myomectomy due to fibroid size, position, or prior surgeries.
If a doctor tells you a vertical midline incision is your only surgical option—and doesn’t offer an alternative like a transverse approach—it may be worth seeking a second opinion.
How Abdominal Myomectomy Is Performed
While this procedure isn’t laparoscopic or robotic in technique, it usually avoids the large midline incision that many patients fear when they hear the phrase “open surgery.”
Here’s how it works:
- A transverse (horizontal) incision about 10 cm long is made at the bikini line, similar to a C-section scar.
- No robotic arms or laparoscopic tools are used.
- The incision is cosmetically optimized and can be combined with plastic surgery procedures to improve abdominal contour and restore muscle integrity, if desired.
Depending on your anatomy, the incision size and closure technique may be adjusted for the best medical and cosmetic outcome.
This method is ideal when fibroids are too large for a laparoscopic approach, but a full vertical midline incision would be unnecessarily traumatic.
How Abdominal Myomectomy Compares to Other Options
Video: What Is a Myomectomy and Which Type Is Right for You?
| Transverse Bikini-Line Myomectomy | Vertical (Top-Down) Incision | Robotic/Laparoscopic Myomectomy | |
|---|---|---|---|
| Skin Incision | Low, horizontal, discreet | Long, visible down the abdomen | 3-4 small port sites |
| Pain & Recovery | Moderate | More painful | Least painful |
| Access for Large Fibroids | Yes | Yes | Sometimes possible depending on patient anatomy & imaging |
| Cosmetic Integration | Available | Rarely coordinated | Not typically included |
Pre-Surgery Preparation for Abdominal Myomectomy
Before surgery, your care team will help you prepare with:
- MRI to assess fibroid size, number, and location
- Pre-op labs
- Medication adjustments, including stopping blood thinners or certain supplements
- Instructions for fasting, bowel prep (if needed), and arrival times
- Lifestyle prep, including smoking cessation, walking, and gentle activity
You’ll also receive thorough counseling about surgical risks, recovery expectations, and optional cosmetic additions.
Recovery Timeline and Expectations
- Hospital stay: One or two nights
- Return to desk work: 2-6 weeks, depending on patient experience
- Heavy lifting/exercise: Avoided for 6–10 weeks, with gradual reintroduction of physical activity
- Pain management: Stronger medications may be prescribed.
- Diet: No special diet required, though bland foods are often best early on
Abdominal Myomectomy Risks and Possible Complications
As with any surgery, there are some risks, which include but at not limited to:
- Blood loss and anemia: Many fibroid patients already have low hemoglobin; some may require treatment prior to surgery to minimize post-surgical risk. This may include iron transfusions or medication to increase hemoglobin levels. Still, some patients may require blood transfusions following surgery.
- Adhesions (scar tissue): More common with open surgeries than laparoscopic ones
- Infection or delayed wound healing
- Fibroid recurrence: Fibroids can grow back, especially in younger patients
- Injury to nearby organs
- Pregnancy complications (although it is important to note that fibroids themselves can cause pregnancy complications as well)
Fertility and Future Planning
As you consider your options for addressing uterine fibroids, keep these considerations in mind:
- If you want to preserve fertility while addressing fibroid symptoms, myomectomy is an excellent option. If symptoms return later on, you may consider additional treatments in collaboration with your doctor.
- You should wait 3 to 6 months after surgery before trying to conceive, depending on your doctor’s instructions.
- Tummy tuck should only be done after childbearing is complete, as pregnancy can reverse the repair
- Fibroids may recur, but symptoms often remain controlled for years. We recommend monitoring for future fibroids through regular imaging and treating with medication or further procedures if desired.
Success Rates and Long-Term Outlook for Abdominal Myomectomy
Abdominal myomectomy performed by a highly trained gynecological surgeon often leads to a significant improvement in quality of life for women experiencing uncomfortable symptoms of uterine fibroids. Studies show that women experience a significant improvement in pelvic pain, heavy menstrual bleeding, pressure, and sexual complaints following myomectomy.
Additionally, one retrospective study showed that myomectomy surgery improved pregnancy rates by 55.7% in patients with unexplained infertility.
Fibroids can return, the average recurrence rate is 30% over 10 years, with a higher risk for women with more than one fibroid at the time of surgery. Still, treatment options are available if fibroids come back. Overall, patients at ESSE Care consistently report improved quality of life, body confidence, and emotional relief after undergoing this surgery.
Follow-Up and Post-Surgical Support
Recovery doesn’t stop when you leave the hospital. ESSE Care provides ongoing support including:
- Follow-up visits at 1–2 weeks and as needed
- Wound checks and drain management (if placed)
- Monitoring for complications
- Referrals to physical therapy or integrative recovery services, as needed
Integrated Care for a New Beginning
At ESSE Care, we believe your surgical experience should reflect your medical needs and your personal goals. Whether your primary concern is symptom relief, fertility, or body confidence, our coordinated team of surgeons ensures you leave the hospital with a renewed sense of health, autonomy, and self-trust.
Schedule a consultation with an ESSE Care doctor today to discuss whether myomectomy is right for you.
