I had a full tummy tuck with muscle repair. Ended up with a vertical scar where old belly button was which I knew was a possibility. It feels like it is sutured to the muscle below and pulls in creating a "butt" effect with the extra skin that is still there. There's a pocket of fat/skin on my right that protrudes where the two incisions intersect. Is this something that can be revised? I asked my PS and his response was that it could end up worse :0/ Thanks for any input you may have!
Is the Vertical Scar from Old Belly Button Sutured to the Muscle?
Doctor Answers 4
This can be revised with low risk of worsening.
It's too bad your abdominal skin was so tight in surgery that your surgeon could not eliminate the vertical scar. The area of protrusion adjacent to this scar is partly swelling from lymphatics that have not yet recovered completely, but there is also a component of the perpendicular scars causing a degree of "purse-string effect" similar to what a curving or semicircular scar will do. This also can be revise quite easily with minor liposuction or even direct excision if more of the scar can be removed.
I understand your surgeon's reluctance to re-open Pandora's box, particularly as the problem cannot be completely 'removed." Only an improvement can be expected, and of course there's the issue of cost.
Perhaps this was discussed in advance of your tummy tuck surgery. If so, you know that your surgeon will almost certainly not charge a surgeon's fee. But you would be responsible for the operating room and any anesthesia charges, even if this was done in your surgeon's own facility. This is always an uncomfortable discussion, which is why I do this with every patient prior to their initial surgery. Then I do my best to avoid the "free" no-surgeon's-fee, additional-cost-to-the-patient, re-do surgery by doing my best work the first time. And hopefully my patients are the most compliant their first time also!
Talk this over with your surgeon! Best wishes!
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Adherent umbilical scar
There is less fat around the belly button so it can "sink" and scar down to the muscle underneath. It is not interntionally sewn to the muscle. A revision is simple and should not end up worse. The scra needs to be completely released from the muscle and as much of it excised as possible. The fat layers need to be brought back together which means your horizontal scar may need to be opened a ways in either direction, but the procedure is nothing like the first one in the way of recovery. You have a nice result otherwise. Tell your surgeon you think so, too but would like him to put the icing on the cake so you feel comfortable showing off his good work.
I would recommend you obtain a second opinion, and they agree, then perhaps they are right. Thank you for your question and good luck with everything.
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Not Sutured, but scarred
The vertical incision you have is probably scarred (not sutured) to the underlying wall because there is not as much fat underneath the incision ( the belly button area is thinner) Less subcutaneous fat means that the scar can stick down. This, and the minor contour difference, can be easily revised.