Is tummy tuck possible with large existing vertical scar? (Photo)

Question

I had major abdominal surgery 10 years ago to remove a tumor (size of a volleyball!) and ovary. The scar is from belly button to pubic bone. Between the stretch from that tumor and my two pregnancies following, I am so self conscious about my stomach. I'm a good 30 pounds from my goal, but no matter my weight, my lower stomach always looks like a butt

Tek Przylecki, MD, FACS · Answer

Hello and thank you for your question. Although the ultimate decision on whether you are a good candidate for surgery needs to be made by your consulting surgeon after a thorough review of your medical history and physical exam, a vertical scar does not preclude you from having a tummy tuck (abdominoplasty). In fact, we often incorporate a vertical component in the procedure for patients who have massive weight loss and have both a horizontal and vertical skin excess. This is often called a Fleur de Lis procedure. In your case, most of the scar would be removed during the operation likely leaving you with just a horizontal scar. Your surgeon would need to be sure you do not have a ventral hernia from your prior surgery as this should be corrected during your surgery if it is present. I hope this helps answer your question and I wish you luck on your journey!

J. Timothy Katzen, MD, FACS · Answer

Thank you for your question and for sharing your history and photos. Based on the information you provided, most plastic surgeons would agree that you are an excellent candidate for a tummy tuck, even with your existing vertical scar.

During a tummy tuck, the excess skin and fat from the lower abdomen (from the pubic region to the belly button) is removed. This area aligns perfectly with the location of your vertical scar, meaning that the scar will be completely eliminated in the process. The typical tummy tuck incision is made low in the pubic area and extends outward toward the hips. After the abdominal muscles (rectus muscles) are tightened to correct any separation (rectus diastasis), the skin above the belly button is pulled down, smoothing the entire abdominal area.

Given your history of abdominal surgery and the changes from pregnancies, a tummy tuck could greatly improve the appearance of your stomach and resolve your concerns about the lower abdomen. Your vertical scar would be replaced with a low, horizontal scar that is easier to conceal.

It sounds like you would be an excellent candidate for this procedure, and I hope this helps answer your question.

Sincerely,
Dr. Katzen

Matthew C. Camp, MD · Answer

Great question. In the tummy tuck procedure, the skin that bears the vertical scar will be completely removed, eliminating the apparent “Front Butt”. You will have a horizontal scar going hip to hip, but this will be easily hidden by your underwear, as this scar is very low - basically at the same level of a c section incision. The procedure will give you a tremendous improvement in your appearance, and hopefully your enjoyment in life.

Rajaie Hazboun, MD, MBA · Answer

Thank you for posting your questionfirst of all I would like to congratulate you on your resilience and for getting over the tumor you had.I am basing my answer on the limited information I have and the picture presented , but for a more in depth answer I would recommend seeing a surgeon in person. Your vertical scar does not exclude you from being able to undergo an abdominoplasty , on the contrary an abdominoplasty might fix a lot of the issues you were mentioning. that being said, it's hard to tell from the picture how your umbilical blood supply was affected with your previous surgery, most likely it will be fine but there is a chance you might have some healing issues with your umbilicus. Also more likely than not your surgeon will be able to completely remove all your vertical scar as it appears to be mostly located below your umbilicus but there is a slim chance they won't be able to and you might end up with a small vertical scar I also mention that since it appears from the picture that your umbilicus lies naturally in a high position but pictures can be deceiving . Everything considered you will more likely than not be very pleased with the result that you will get with an abdominoplasty.

Ramin Behmand, MD, FACS · Answer

Yes, a tummy tuck is definitely possible even with a large vertical scar, and it can significantly improve the appearance of your abdomen. Often, the scar can be partially or even completely removed during the procedure. The quality of your upper abdominal skin appears to be excellent, which will help enhance your final result by replacing the looser, stretched skin of the lower abdomen. Considering the effects of your previous surgery and pregnancies, a tummy tuck can address loose skin, muscle separation, and reshape the lower abdomen. While being closer to your goal weight is ideal, your current situation is quite common, and a consultation will help determine the best plan for your specific needs.

Dr. B.

Dr. B.

Arif Eroglu, MD · Answer

Hello; In tummy tuck, the incisions; that will cause for problems are the vertical and especially, the horizontal incisions above the belly button. There is no problem; in the incisions below the belly button. Lipoabdominoplasty method; seems like it can be easily performed on you.

Igor Burko, MD · Answer

Hello, my name is Dr. Burko and I am a Plastic Surgeon at SY Aesthetics in NYC. Based on your photo, I do think a tummy tuck is likely possible. You appear to have skin excess with likely a diastasis of your abdominal muscles.
The best way to tell is to perform a physical examination.
I recommend you consult with a plastic surgeon to discuss your goals, expectations, and options.

Michelle Zweifler, MD · Answer

A tummy tuck is usually possible with an existing vertical scar from belly button to pubic bone; this is the excess tissue that is removed with any abdominoplasty.  First one needs to be examined to rule out any hernia, often hernias are repaired at the same time of the tummy tuck.  Infrequently, a short vertical scar from one’s umbilicus may remain after abdominoplasty.

Matthew S. Kilgo, MD · Answer

Hello. In general, an abdominoplasty can be performed safely after prior abdominal surgery. You would also have the added benefit of removing the lower midline scar in its entirety. It would be very important to have a thorough physical examination and possibly imaging to exclude any hernias along the midline scar or in the umbilical region. In addition, it would be ideal for you to achieve your goal weight prior to undergoing a body contouring procedure to minimize change that could potentially adversely impact your results with additional weight loss after the surgery. I hope this helps.

Gary M. Horndeski, MD · Answer

Yes, the large vertical scar will be excised completely at the time of tummy tuck.  You are a good candidate for surgery.

Best Wishes,

Gary Horndeski, M.D.

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