I had surgery 3 weeks ago. The doctor marked where I wanted the scar given the underwear I wore, but the scar is about 1" higher than that now, so not concealed by my underwear. He says it will drop over the next few months, but I don't see anything online supporting that. Will it drop? How much and when? Thank you for your help!
Will a Tummy Tuck Scar Drop over Time?
Doctor Answers (17)
Drifting tummy tuck scars...
Tummy tuck scars are more likely to drift in an upward direction rather than downward. This is due to the upward pull on the scar from the upper abdominal flap. It's possible your surgeon feels the postoperative swelling is making the incision placement appear displaced, and once it goes down it will be in a slightly different location. I'm not sure that will happen, but in any case, 3 weeks after surgery is too early for any revision. I would recommend allowing time for your incision to heal and the swelling to subside. I would suggest giving it at least 6 months before any revision.
Tummy tuck scar too high...will it drop?
In my opinion, in a word, no. We work hard to try to place the scar low and as accurately as possible, but there is always a small amount of variability as to where it will end up and patients should be warned of this. Some surgeons try to avoid leaving a small vertical scar from closure of the old umbilical site by raising the whole scar higher. I think this is not a desirable trade-off. If over time, perhaps a year or two, your skin relaxes a bit, then maybe the scar can be lowered a bit, but it depends on how much relaxation of your tissues you get.
Tummy tuck scars - how to make a lower scar
Scars for a tummy tuck will end up roughly midway between the upper incision (usually just above the umbilicus) and the lower incision. Sometimes if the upper abdomen releases more than anticipated, the scar will be a bit lower, for example if the patient has had a lot of scarring from a prior liposuction procedure, or has a great deal of upper abdominal looseness. But generally, the incision ends up slightly higher than midway between the umbilicus and the lower incision.
So why wouldn't every doctor just make a really low incision, therefore ending up with an ultimately lower final scar? Because it is not always possible to take out everything between the very low scar and the umbilicus, especially in fit women who do not have have a lot of loose skin. A highly reputable doctor will do everything possible to get a low scar. A lazy or unqualified one may not; I have seen many cases where doctors do not do a sufficient dissection on the upper flap, and therefore the downward mobility is limited, raising the ultimate scar. A wise doctor will also not close things too tightly: this will lead to a wide, unsigtly scar.
In fact, ironically, fit patients end up with higher incisions when they have a conventional tummy tuck!
Location of incisions is important, so doctors and patients should discuss frankly where the incisions will end up. Scar position generally does not change, but scars usually lighten considerably, especially with laser therapy, creams, etc.
Now, there are many in-between short scar procedures that can be used that are neither mini tucks nor full tummy tucks that can allow lower placement of the incisions but still enable full tightening of the fascia.
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TT scar will not drop
When marking an abdominoplasty incision it is imperative that the abdominal tissues be pulled upward firmly as they will be afterwards (more in the center than on the sides). If they aren't the incision will be too high which may be what happened to you. It takes practice. I made this mistake marking my own abdominoplasty incision twenty years ago. The scar has not dropped even a little since then. The scar faded over a year or more and doesn't bother me, but it does remind me not to make the same mistake when marking my patients. There are trade-offs to having a lower abdominal scar. You may end up with a vertical scar where the incision was made around your belly button. Many surgeons wish to avoid this. I discuss it with each patient, show them photos and let them choose.
Tummy Tuck Scar Locations Are The Result Of Presurgical Markings And The Tension Of The Wound Closure
Once the horizontal tummy tuck scar is set at the completion of the procedure, it largely is not going to change after it heals. It most certainly will not drop and may slightly raise up a bit. (although not much) Although tummy tuck closure appears to depend completely on the upper skin flap being brought down to the lower incisional edge above the pubis, it is not really a complete unidirectional tissue shift. Depending on whether it is a mini- or a full tummy tuck and what the quality of the remaining abdominal skin is like, tummy tuck closure is a bidirectional tissue shift that may range anywhere from 95:5 to 85:15 ratio between the shift of the upper and lower abdominal skin flaps. This has to be factored into the initial incision marking and where the patient can accept the final tummy tuck scar location. Unfortunately, the lower abdominal skin flap (incision to pubis) is not a fixed structure and it will move upward to some degree as the final closure is done.
There is hope...
Picking a location for the tummy tuck incision site take s some practice and experience. In general its nice to have the incision as low as possible because then it can be hidden in nice lingerie, undergarments or swimwear.
If your surgeon based the incision on the underwear location and didn't take into consideration displacement of the skin with the procedure then sometimes it will end up riding higher than anticipated.
If there is still ( hopefully) some redundant excess skin in the tummy /abdominal area , some surgeons can lower an abdominoplasty incision by creating an incision lower than the the initial incision and remove the skin in between the first incision and the new lower incision.
Good Luck to you.
Kimberly Henry M.D.
San Francisco, CA
Will an abdominoplasty scar drop?
It is unlikely that your scar will drop.
However, as it fades it will be less of a problem for you. Most patients make a few clothing adjustments to keep the scar concealed, and I rarely hear any complaints about the scar.
Remember that the final scar location is determined by the 'tug-of-war' between the tissues above and below the incision. It is not always possible for the surgeon to guarantee its final position.
Tummy Tuck Scar Position
I doubt the scar will drop much . It has been my experience that they tend to rise some as the patient straightens out. In general, I like to see at least 4 inches between the umbilicus (belly button) and the top of the scar - more if possible. Scar position is one of my 3 "keys" to a good tummy tuck.
Position of Tummy Tuck Scar
Many changes do take place over the first three months after surgery and maybe even some "drift" of the scar, but not much. Everything is still tight and swollen now and as this decreases you will have a much better idea of the final result.
After things have completely relaxed a few months down the road there may be enough looseness to move the scar down some more.
Interestingly in marking the tummy tuck incision line it is important to pull the skin up tight in the area and then make your mark, because all of that area is going to pull up at surgery just like the skin in the upper abdomen will pull down.