5 Telltale Signs of a Botched Tummy Tuck

The tummy tuck, a surgery that removes excess skin and fat from the abdomen and lifts the belly button, is one of the more intense procedures out there: it can come with weeks of downtime, significant swelling, and pain that, while manageable with pain meds, can still be uncomfortable when you laugh or sneeze. 

That said, it’s one of those procedures that most people are happy with, with a 95% Worth It Rating on RealSelf. While abdominoplasty is known for helping to address issues after childbirth, like diastasis recti, it’s experiencing increased popularity—possibly with the rise of medications like Ozempic, which lead to rapid weight loss and, often, sagging skin. In fact, 2023 saw a 5% increase in tummy tuck procedures in the U.S. compared to the previous year, according to the American Society of Plastic Surgery. 

But it’s not without drawbacks. “For tummy tucks, risks may include infection, bleeding, wound healing problems, and unfavorable scarring,” says Dr. Lyle Leipziger, a board-certified plastic surgeon in New York City. And because abdominoplasty is so involved—and can be combined with liposuction, to contour the waist and flanks, or a breast lift to create a full mommy makeover—there are a few ways in which it can also go wrong. Here’s what to look for in a botched tummy tuck.

Misshapen belly button

The most common telltale sign of a botched tummy tuck is the size and shape of the belly button, according to Dr. Jerry Chidester, a board-certified plastic surgeon based in Draper, Utah. “During abdominoplasty surgery, many times a scar has to be made around the native belly button in order to pull the skin down toward the pubic area and remove the excess skin and fat,” he says.

There are various ways to shape and mold the original belly button in its new location to look natural—and if it doesn’t, then it can look…weird. For that reason, “the most obvious sign of a bad belly button is a belly button that is too large in size or way too small,” says Dr. Chidester. “This can be a dead giveaway for a ‘botched’ tummy tuck.”

Visible scarring

A scar is tough to avoid with a surgery as big as a tummy tuck—but a good one is virtually invisible. However, a poorly positioned scar can be a sign of a botched tummy tuck. “When the scar is placed too high on the lower abdomen, it can be very visible in even regular clothing,” says Dr. Chidester. On the other hand, the scar can also be placed too low, especially along the outer waistline. The ends can hook downward, he says, allowing it to peek out of swimsuits or activewear.

Abdominal contour irregularities

The goal of a tummy tuck is a generally flat abdominal contour—not one with lumps. That could be an irregularity of the abdominal wall contour, which could happen for a number of reasons. One is a seroma, or a collection of blood plasma under the skin—and it’s fairly common after tummy tucks, with one study finding it in roughly 11% of cases worldwide.

It can also happen if you gain weight after your surgery, since that can lead to what Dr. Leipziger calls “disproportionate fat deposits.” And if you don’t rest up during healing and, say, head back to the gym too soon, you risk tearing the abdominal muscle repair, which could also contribute to a bulge.

“Dog ears”

An offshoot of both abdominal contour irregularities and scarring can lead to “possible fullness at the lateral ends of the incision,” says Dr. Leipziger. These bulges, which can appear on either or both sides of the scar, are referred to as “dog ears,” due to the way they look (which, not surprisingly, is similar to dog ears in that they hang out over the rest of your skin). And if the scar is placed too low or too high, they can be visible through your clothing.

Necrosis

The rarest sign of a botched tummy tuck is also the most serious, and that’s necrosis, or tissue death, of the actual tummy tuck flap—which stems from a lack of blood supply in the area. “In some situations, extremely aggressive dissection or liposuction can lead to full tissue and skin loss, typically in the middle-lower portion of the tummy tuck flap,” says Dr. Chidester.

Not only can this cause distorted scarring, but it could also necessitate reconstructive surgery. However, the incidence of skin necrosis after a tummy tuck is around 4%, and a major risk factor for it is tobacco use—which is why many plastic surgeons will ask smokers to stop for weeks (if not entirely) before the procedure.

What you can do about a botched tummy tuck

Certain issues, like small bulges, can be addressed easily; for instance, a simple liposuction procedure can “improve small areas of fullness,” says Dr. Leipziger. When it comes to scarring, however, placement can be a bigger factor. For instance, “if the horizontal scar is too high, it can end up being too close to the belly button scar, making it nearly impossible to correct,” says Dr. Chidester.

As for a misshaped or misplaced belly button, one option is belly button surgery, or umbilicoplasty. Some surgeons actually fully remove the belly button during a tummy tuck and then do belly button surgery separately; this can minimize stress or tension on the incision during the tummy tuck healing process, and the belly button can be placed in the optimal position once your abdomen has healed.

A revision surgery—what Dr. Leipziger calls an “extensive tummy tuck redo”—is always a last resort, but it follows “a thorough examination of the problem areas, to understand the best course of action,” says Dr. Leipziger.

Most important of all, do your homework before you schedule your tummy tuck—which means opting for a plastic surgeon who is board certified and has years of experience. To minimize the chance of a botched tummy tuck, your surgeon should “provide a comprehensive consultation, to review your medical and surgical history, your goals and expectations, and the risks and benefits of the planned procedure,” says Dr. Leipziger. They’ll know what complications and side effects to watch out for—and best ensure that you’ll love your final results.