Medlen has second Tommy John surgery since 2010

LAKE BUENA VISTA, Fla. -- After spending more than a week knowing it was inevitable, Braves Kris Medlen spent a portion of Tuesday afternoon undergoing Tommy John surgery for the second time in less than four years.

Dr. James Andrews has performed both of these surgeries on Medlen, who first underwent the procedure on Aug. 18, 2010. Pitchers generally need at least 12 months to recover from the process. Medlen's timetable for recovery might be longer because this was the second time Andrews had to perform the surgery, which replaces the elbow's ulnar collateral ligament with a tendon.

Andrews transplanted a ligament from Medlen's right wrist to complete Tuesday's procedure. A ligament from Medlen's left hamstring was transplanted to the elbow during the 2010 procedure.

Medlen and Brandon Beachy left Braves camp on Sunday to travel to Pensacola, Fla., in preparation of the evaluations Andrews made on Monday. Beachy confirmed that he did not receive a favorable prognosis. But before undergoing his second Tommy John surgery in less than two years, the right-hander will get another opinion from Dr. Neal ElAttache in Los Angeles on Wednesday.

Andrews also performed Beachy's initial procedure in 2012.

When Medlen received confirmation that he would need to undergo the surgery for a second time, he vowed that he will attempt to pitch at the Major League level again.

"I approach this process with the same drive that I've had my entire life and will do everything I can to come back from this thing twice," Medlen said.

While the Braves have said they will evaluate the rehab protocols they have used for pitchers coming off Tommy John surgery, Medlen has indicated he will likely have to alter his mechanics. The 28-year-old right-hander knows that he puts extra strain on his elbow when he throws his changeup.