This topic is about planning surgery to reduce the size of an oversized stoma, which is currently about 70 mm by 65 mm. The person involved is preparing for surgery and is looking for advice and insights on how to proceed. Here are some helpful points to consider:

1. **Questions for the Surgical Team**
- Ask why the stoma has enlarged. Is it due to changes in the bowel wall or a hernia?
- Inquire about the number of similar procedures the surgeon has performed and any complications that arose.
- Discuss whether bowel length will be affected and how much might be removed.
- Find out how the abdominal wall defect will be closed and what the plan is for preventing hernias, such as using mesh or a support belt.
- Clarify any expected recovery restrictions, like limitations on abdominal exercises.

2. **Understanding the Surgical Approach**
- A stoma of this size typically requires more than just tightening. The usual procedure involves closing the old site, removing a section of the bowel, and creating a new stoma, often on the opposite side of the abdomen.
- The new stoma should be positioned away from scar tissue to ensure proper appliance adhesion.
- The goal after revision is usually a stoma about 25 mm in diameter.

3. **Seeking Multiple Opinions**
- It's wise to consult with at least two independent surgeons to compare techniques and ensure confidence in the chosen approach.

4. **Hernia Awareness and Prevention**
- Oversized stomas and their revisions can increase the risk of hernias. Discuss the use of support garments or belts and establish long-term lifting limits.
- Avoid heavy lifting; some people recommend keeping loads under 10 pounds.

5. **Managing the Stoma Before Surgery**
- Since the stoma is flush with the skin, it's crucial to position the pouch carefully to prevent leaks and skin irritation until the surgery takes place.

6. **Resources and Personal Experiences**
- Look for articles and resources that discuss stoma size changes, such as the OakMed article on why stomas might get bigger, which can provide additional insights.

By considering these points, the person can better prepare for their upcoming surgery and manage their stoma in the meantime.