I am getting a tummy tuck and want my pyloric stenosis scar revised as well. My surgeon wants to do a vertical incision in addition to the horizontal incision. Otherwise he said if just doing a horizontal incision, he would recommend it be higher in order to avoid skin death when dealing with the secondary scar, i.e. the pyloric stenosis scar. I am concerned about a vertical cut but equally concerned about a high horizontal cut. Please look at my pictures attached and advise. Thank you.
I Am Getting a Tummy Tuck and my Surgeon Wants to Do a Vertical Cut, is This Advisable? (photo)
Doctor Answers 4
Tummy Tuck with Both Transverse and Vertical Scars (Fleur de Lis) Procedure
I'll start by saying I fully agree with your surgeon.
Plastic surgeons HATE scars. Every scar we leave is thought about and mulled over. We do not create scars with the ease other surgical professions do. Moreover, since we are judged by our scars, we take great pains to close them with great care. So, the longer the scars, the longer the process of closing these wounds.
So WHY would your surgeon give you LONGER scars and make his work harder?
- Your baby days Pyloric stenosis scar has compromised the blood flow inferiorly through the skin raising the likelihood of skin loss once the skin has been lifted off the muscles. A Verical scar would allow removal of this scar damaged skin.
- Using a Vertical scar would allow a SHORTER transverse scar since most of the skin excess is in the area of the belly button
- You have a lot of excess skin above the belly button. A lot of this skin can be better removed via a vertical scar.
In summary, in your case a Fleur de Lis (Lilly Flower) Tummy Tuck, would give you a MUCH flatter tummy in a much safer way.
Peter A Aldea, MD
Tummy Tuck Considerations?
Thank you for the question.
As you know, your tummy tuck is complicated came by the existence of the previous scar. I would suggest that you adjust your expectations and advise your surgeon to do his best to achieve the best aesthetic result possible while maintaining SAFETY as the first priority.
If safety considerations indicate a higher incision or a vertical incision would be helpful, I suggest you go with it.
I hope this helps.
Pre-existing abdominal scars and tummy tuck
Some prior abdominal scars can be incorporated into the area that is removed during a tummy tuck while other incisions, such as yours, require alteration of the standard tummy tuck technique to avoid complications. The incision that you have may have interrupted the blood supply from the right rib cage down to the peri-umbilical area. Your options are several including a lower mini-tummy tuck and a reverse tummy tuck, a higher horizontal incision at the end, or a horizontal and a vertical. Which one may be best for you will depend on your goals. Please discuss this carefully with several well trained plastic surgeons prior to proceeding.
All the best,
Dr Remus Repta
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It sounds as though your surgeon is giving your abdomen the thought that it deserves. Old scars (like the one you have) can significantly diminish blood flow into the area below the scar ( a watershed area). This can increase the risk of poor wound healing. The answer really is dependent on how much skin laxity you have which is best determined by your physical exam. Good Luck!