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10", 30+ Year Old Scar and Abdominoplasty? (photo)

Thought I could have a full tt, w/ good results, not sure now. The entire scar, can't be seen in the pic, it goes further back & angles down toward my hip. Can I have a full tt & lipo? Is mr poss. if needed? What kind of result can I expect? Will I have flat abs? Approx. where will the scar land? What about c/s scars I have 2? What are the risks? Is this an unwise choice for me? Lost sensation for long time, but it returned. Dont want a fleur-de-lis, would that make a dif? Much Appreciated!

Doctor Answers (12)

Old Scars and Abdominoplasty

+1

In a standard abdominoplasty, the low horizontal incision is just above the pubic region, so the skin is elevated upward and relies on blood supply coming from the upper abdomen.Theoretically, an old gallbladder surgery incisional scar in the right upper quadrant could interfere with some of that circulation putting the lower abdominal skin at risk for poor healing.  However, with the passage of time, alternate blood vessels seem to grow in to nourish this area, so your old scar should pose much risk to safe healing.  You could have muscle repair, removal of the old c-section scars, liposuction, and a successful, smooth recontouring.

Web reference: http://www.pbplasticsurgery.com

West Palm Beach Plastic Surgeon
5.0 out of 5 stars 5 reviews

Challenging Tummy Tuck

+1

I've done many cases similar to yours and have never had an issue with skin survival as long as a substantial period of time has passed between the original surgery and the tummy tuck.  The greatest potential downside is that the lower abdominal scar may not be as low as we normally try to place it because we would be removing the entire old scar.  I agree that a Fleur-de-lis procedure is unnecessary and would not provide any advantages!  The good news is that a tummy tuck can give you an excellent result with a very flat abdominal wall.  Good luck...

Manhattan Plastic Surgeon
5.0 out of 5 stars 19 reviews

30+ Year Old Scar and Abdominoplasty

+1

These right subcostal incisions from removing gall bladders used to be quite common, but now with the advent of laparoscopic surgery they are far less often seen. The incision does add some amount of risk to the blood flow, but not too much. TT were done on many patients with this incision in the past. 

The C-section incision adds no hazard. The TT incision will be at or below the level of those incisions. The usual expectation is numbness that improves, though not to normal, over the course of a year. 

Fleur de lis patterns are useful when there is also horizontal excess, but I see no such problem here, so that would not be needed. 

As far as how flat an abdomen you will have, I can't say without a side view. Most get improvement.

When you ready for an in person consultation, RealSelf has listings of surgeons in your area. You should consider cross referencing the listings from the The American Society of Plastic Surgeons (plasticsurgery dot org). A listing in the ASPS website assures you that your surgeon is not only board certified,  but also is a member in good standing of the major plastic surgery organization in the U. S.

Thank you for your question, best wishes.

 

Seattle Plastic Surgeon
4.5 out of 5 stars 28 reviews

Tummy tuck with that scar

+1

As usual, an in-person consult with a BC PS is your first step.  That scar on the right may complicate the surgical plan, but you can still get a nice result.  Best of luck to you.  The c/s scars likely will be cut out. 

Baltimore Plastic Surgeon
5.0 out of 5 stars 10 reviews

Tummy tuck in non-virgin abdomen

+1
That's what an abdomen with prior surgery is called. The answer is that it will not disqualify you from having a tummy tuck but will make the dissection more difficult. You don't need a fleur de lys approach. The abdominoplasty will tighten your musculature and improve your cosmetic appearance but an exam would be necessary to comment on scar placement. See a board certified plastic surgeon who is experienced and well-recommended for tummy tucks. So many patients have had gall bladder or appendix surgeries not to mention C-sections so it is a common inquiry.
New York Plastic Surgeon
5.0 out of 5 stars 8 reviews

Tummy tuck revision with scars

+1

You can absolutely improve your abdominal contours and lower tummy scars with a revision abdominoplasty.  The scar from your gallbladder surgery is mature enough that it poses only a slight additional risk.  Make sure you see a Board Certified Plastic Surgeon who has experience with revision surgery.

Tampa Plastic Surgeon
5.0 out of 5 stars 11 reviews

Tummy Tuck and Previous Abdominal Scars?

+1

Thank you for the question and picture.

Your previous C-section scars will not pose a problem when you undergo tummy tuck surgery. However, the scar along the right upper quadrant of your abdomen may expose you to additional risks.

 There are certain maneuvers that can be performed to help minimize the risks associated with the previous upper abdominal wall scars.  The good news is that  after 30 years, there is a good chance much of the blood flow around the abominable scar has "reconstituted”

You will be able to have a full tummy tuck and muscle repair done. Of critical importance will be selection of plastic surgeon who can demonstrate significant experience helping patients in your situation.

 Best wishes.

 

Web reference: http://www.poustiplasticsurgery.com/Procedures/Procedure_tummyTuck.htm

San Diego Plastic Surgeon
5.0 out of 5 stars 626 reviews

Old scars do pose a problem with tummy tucks

+1

What a great question!  Since the advent of laproscopic surgery over 20 years ago we rarely see the old right upper quadrant scar associated with an open cholecystectomy (gall bladder removal). Gall bladders are now removed with small incisions and video cameras. Old scars on the abdomen do pose a problem in planning a tummy tuck.  They interfere with the blood supply that is necessary to keep the skin alive with a tummy tuck procedure.

Every tummy tuck procedure is personalized and yours will be also.  You can still have a "tummy tuck" but it will have to be modified because of your scar.  Please see a board certified plastic surgeon who has experience in this type of procedure.  You are at higher risk of developing post op skin death and complications relating to that.

Good Luck

Omaha Plastic Surgeon
5.0 out of 5 stars 44 reviews

Tummy tuck and prior abdominal scar

+1
Dear Camie, Your upper abdominal scar does pose a challenge in your abdominoplasty plan. Depending on your examination, it may be removed if you have enough laxity above, otherwise minimal undermining needs o be performed below the scar to keep the skin alive. Either way you won't need a fleur de lis abdominoplasty. Best of luck.
New York Plastic Surgeon
5.0 out of 5 stars 38 reviews

That old scar on your abdomen is an important consideration in how the tummy tuck is performed

+1

I agree with you that the fleur-de-lis scar is not a good option.  I never use it.  Your old abdominal scar (gall bladder removal?) is a problem.  It cuts off the blood supply just below the scar so that if you have a normal full tummy tuck, you are likely to have a complication with skin loss just below this scar, which you don't want, obviously.  Another option, however, is including that scar in the skin removed by the tummy tuck.  The disadvantage is that the scar will end up a little higher than we would like.  However, you have such loose skin that it may still be possible to get it down below your panty line where it won't be a problem for you (may or may not be possible to also contain the C-section scars in the resection).  The trick is for the surgeon to flex the operating table during surgery to allow placement of the scar as low as possible.  Experienced plastic surgeons know how to do this.  It does mean that it will take you a week or two to stand straight, but most women don't mind this temporary inconvenience if it means their scar can be low and horizontal, with no vertical scar (which looks ugly and is avoidable).  Yes, with simultaneous liposuction you can expect a dramatic difference and a much flatter tummy.  So yours is a difficult case and demands a high level of operator skill and experience.  But with proper consideration, you are likely to be very pleased with the result.  I've attached a link in case you would like to view the scars.

Web reference: http://www.swansoncenter.com/content/ideal-body/procedures/abdominoplasty/patient-photographs.asp

Kansas City Plastic Surgeon
4.5 out of 5 stars 28 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.

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