Tamra Judge Opens Up About 'Painful' Abdominoplasty After Life-Saving Hernia Surgery

Tamra Judge is still feeling the effects of having abdominal surgery late last year.

The Real Housewives of Orange County star went under the knife on Dec. 29, 2022 for a corrective abdominoplasty she says "one of the most painful things I've ever done in my life."

"God knows I've gone under the knife before, but recovering from this has been worse than anything I've ever done," she tells PEOPLE, ahead of her appearance Friday at Sally Beauty in New York City, to celebrate her Vena Skincare line being the retailer's first and only CBD skincare collection sold in-stores. "I mean, I've given birth to four children and even that was easier!"

Judge, 55, decided to have the surgery to fix the placement of her naval, which had been damaged and off-center for over 10 years since she had a life-saving emergency operation to remove a strangulated hernia in 2012.

"I could have died," she recalls of the operation. "And it basically left me with no belly button."

Dr. Donald S. Mowlds, who performed Judge's abdominoplasty, explains to PEOPLE what happened: "Tamra came in with a tough, difficult problem due to the previous surgery she had. A strangulated surgery is really bad and the doctor that had done the operation — which is a major surgery, by the way — was pretty heroic and did an incredible job. Unfortunately, the down side to these surgeries is that for the type of incision they use, they release the belly button from where it naturally attaches to the abdominal wall. And sometimes, when they tack it back down, the skin sort of re-drapes and can create some unevenness to the abdomen."

"That's was the case with Tamra," the board certified plastic surgeon continues. "The incision went basically halfway up the mid-line of her stomach and around her belly button, causing the slit-like belly button. But it was out of place, making her proportions of the abdomen off. And it led to her complaints of the skin laxity above, the firmness below, and just everything that we sought to treat.

In Judge's eyes, it's a lot simpler.

"I basically had no belly button," she says. "I'd have to remain extremely thin for my stomach to look normal and even then, it was never really there. It was just one of those things I hated about myself. People on social media would be like, 'Oh she clearly got a tummy tuck, look how messed up her belly button is!' You know how many times I'd have to show the actual picture of the hernia to prove them wrong?! I didn't want to do it anymore."

So during a trip to see her longtime Newport Beach plastic surgeon Dr. Milind Ambe for a little routine Botox, Judge met Dr. Mowlds — a breast and body specialist who had just moved into Dr. Ambe's office. "I don't know how it came up, I think we were talking about the hernia but I showed him my non-existent belly button and was like, 'Can you fix this?' " she tells PEOPLE. "And whereas most doctors I'd talked to in the past were like, 'I'm not touching that,' he was like, 'Oh I can fix that.' "

Dr. Mowlds proposed an abdominoplasty — which, though synonymous with tummy tuck, can cover an array of abdomen fixes, he says, including treating old scars, skin re-draping and more.

As the operation drew closer, Judge began to have doubts. "I started thinking, 'Oh my God, am I being too vain?' I know what abdominal surgery feels like, I was hospitalized for five days last time and it probably took three months to get over it. So I kept wondering, 'Should I back out?'

"Thank God I didn't because while he was in there, Dr. Mowlds found another hernia."

The second hernia was a surprise to everyone. "It was in her upper abdomen," Dr. Mowlds says, noting that it developed thanks to a small hole in the fascia wall. "It was a good thing I saw it. It was sort of in its infant stages, probably about the size of a little bit bigger than a quarter, and I put some stitches in that to basically fix it forever."

"He saved me from another emergency surgery," says Judge, adding that there was a spiritual message that later proved to her how important this was.

"I'm a huge believer in everything happens for a reason and afterwards, my psychic friend Scott Cruz sent me a message out of the blue and said, 'I just got this feeling, are you okay?' I said, 'Yeah, I'm fine. I had surgery.' And he goes, 'Tamra, your grandmother is telling me that you have her to thank.' And my grandmother died of intestinal issues. So I got chills and realized what a blessing it was that I did this."

Surgery wound up being 5½ hours. During that time, Dr. Mowlds removed Judge's belly button and constructed a new one.

"Moving the belly button back wasn't an option, so I started from scratch," he says. "And that's the part that you have to do some healing tricks on post-op, because the hardest part about making a new belly button in a really thin person like Tamra is getting the depth to make it look natural. So you really want to give that shadow and contour break to give the imagery of a correct abdomen."

To help achieve that, Judge was given a silicone trainer to wear she affectionally calls "a belly button plug."

"It's basically a cone and you put it in there and tape it down to help shape the belly button during healing," Dr. Mowlds says. "But it's all about building that depth you really need."

Though Judge is up and walking again — and back in her bed after spending weeks sleeping in a recliner — "the swelling is going to take eight months to come down completely," Dr. Mowlads says.

"The first couple of weeks after abdominal surgery specifically are rough," he explains. "You really can't do much because most activity you do engages your core, so you need to really rest."

Judge says she can take a break from intense workouts in the gym right now.

"I normally do crunches but I don't have to anymore because he tightened everything up right now,' " she laughs. "So at least there's that!"

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