Common Tummy Tuck Pitfalls

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I always tell my patients that tummy tuck surgery is not just about removing the apron-like skin and fat in the abdominal area. I feel that a more important goal is to create a new midsection that looks youthful and unoperated. For this reason, I pay great attention to the appearance of navel, natural curves, and proportion of hips and waistline.

Perhaps one of the most common tummy tuck pitfalls—usually committed by inexperienced doctors and non-specialists—is the unnatural navel appearance. The general rule of thumb is to create a tiny hood either on the upper right or left side of the belly button, and avoid the “too rounded” or “too elongated” look.

To further make the postop navel appear natural, it should be placed in its original position and must not be larger than 1.5 cm, both vertically and horizontally speaking.

In tummy tuck or any plastic surgery, there is such a thing as good scarring. It should remain flat, faded that it blends well with the skin, and “thin” that it is barely detectable within a year or so.

While some factors that contribute to aggressive scarring are beyond the control of surgeons and patients—e.g., darker skin, genetic predisposition, personal history, and age (younger individuals are generally more susceptible than older patients)—some variables can be eliminated to minimize such risk.

For instance, I eliminate any unnecessary tension on the skin so the wound and its subsequent scar can heal efficiently, which is done through meticulous stitching technique and reshaping the deeper muscular structure that will support the new contour. My goal is to avoid scar migration, “train track” scars, keloids or hypertrophic scars, and dog ears or puckering of the skin at the ends of the horizontal incision.

Steri strips, silicone sheets, scar massage, and certain creams and gels can also assist in good scarring by breaking up or preventing collagen formation within the dermis.

Residual deformity is another pitfall, although it can be avoided or at least its incidence reduced. For instance, liposuction of the flanks and areas far away from the main tummy tuck incision could prevent the appearance of fat rolls.

Inadequate or over-aggressive tissue removal can also lead to residual deformity, with the latter being more difficult to correct since too much skin has already been excised, leading to the overly tight appearance (usually between the mons pubis and lower abdomen) and destruction of the natural curves.

To avoid botched results, your best bet is to choose a board-certified plastic surgeon who mainly performs tummy tuck and body lift after weight loss (aka body contouring). Nevertheless, having skin that innately lacks elasticity—which commonly occurs after significant weight loss—could still predispose you to some type of residual deformity, although usually minimal and treatable with minor revisions.
Article by
Beverly Hills Plastic Surgeon