Do I have any skin laxity for a tummy tuck revision to lower the scar? (Photo)

Question

I am hoping to have a tummy tuck revision towards the end of this year to lower the scar. I would be very happy if the scar were lowered by 1". When will I know if there is sufficient skin for a revision? Is being able to pinch the skin an indication of laxity? What is the recovery like and are drains required in such a revision? When will I be able to lift my 18 month old son?

Roger Tsai, MD · Answer

Great question!  Honestly, it is difficult to tell with just a photo of a pinch, only with an in person examination could a good recommendation be provided.  There are few factors that come into play other than just a simple pinch test.  With that said, often times the scar can be lowered to a certain degree.  You don't want too much tension on the wound either as that will cause the scar to widen.  The recovery will not be as bad as the first time (usually you do not have to re-tighten the muscle) but most likely you will still need drains.  It is recommended to wait at least 4 weeks before heaving lifting which you would not be able to do with an 18 month old.Best of luck and hope this information helps!- Dr. Roger Tsai   @DrRogerTsai

Richard Baxter, MD · Answer

Skin undergoes stretch after a tummy tuck, so it is likely that you could have the scar lowered. Your restrictions on lifting should be minimal because there would not be any muscle repair needed. However it is not possible to say specifically in your case without an in person evaluation.

Dallas Buchanan, MD · Answer

Thank you for your question. Unfortunately, a picture of you pinching your skin is not helpful. You need an in-person examination with a local board certified plastic surgeon to determine what options you might have for revision. At that consultation, you can review the details of surgery and go over the recovery and activity restrictions. Best of luck!

Gerald Minniti, MD, FACS · Answer

Hello,Unfortunately, your photo offers little help in making that determination. Please go see a few ABPS certified/ASAPS member surgeons who specialize in body contouring. Like with primary tummy tucks, my preference for revisions include progressive tension sutures to optimize the upper abdomen skin tension, maximize skin redraping and movement (and therefore scar lowering potential), and avoiding drains. Keep in mind this is a total revision so that meaningful scar movement can be obtained. Best of luck!

Anita Patel, MD, FACS · Answer

Important questions are when you had the tummy tuck, where the incision is located currently, and if you have enough skin laxity above the incision. The photo unfortunately does not give any helpful information. If you are planning the revision with the surgeon who did your original tummy tuck, then you should go in for a followup to ask this question because it requires an exam to answer. If you don't feel comfortable staying with the same surgeon, then consult with a board certified plastic surgeon to see if you are a good candidate for revision and if the skin has enough laxity to accomplish what you are hoping for. Drains may or may not be required, depending on the extent of dissection. Activity restrictions will also depend on the extent of the surgery, but generally speaking the recovery is less than the original tummy tuck where the ab muscles are repaired.

Daniel Barrett, MD · Answer

Dear kellycookies,it is hard to tell without an examination. I would suggest you to consult a board-certified plastic surgeon. Only after a thorough examination you will get more information and recommendations.Daniel Barrett, MD, MHA, MS 
Certified, American Board of Plastic Surgery  
Member, Am. Society of Plastic Surgery

Curtis Wong, MD · Answer

you must have ample laxity or you will end up disappointed or with a wide scar.  So make sure your surgeon can assure you that your expectations will be met before having it revised, like having your surgeon telling you exactly where your scar will end up.  Lowering scars a lot may require the OR to allow for more undermining of your abdominal flap.

Nicholas A. Flugstad, MD · Answer

It's difficult to say without in person examination. See a local board certified plastic surgeon for an opinion on that. Generally, lowering the scar requires a good amount of the surgery to be redone. If you previously had muscle plication, that should still be intact. Without need for redo plication, the recovery and restrictions should be much easier than your original surgery.

Johnson C. Lee, MD · Answer

Thank you for your photo. An in-office examination will determine if you have enough skin to lower the scar by 1." A pinch test is one part of the evaluation but not the only factor. A revision tummy tuck recovery can be easier/shorter than your original tummy tuck or similar depending on how extensive the revision is. Drains will vary as well depending on what is done. I generally recommend no heavy lifting for four weeks after surgery to avoid injury or release of the muscles or skin sutures which were placed. Hope this helps!Johnson C. Lee, MD Plastic Surgery@drjohnsonlee

Robert H. Hunsaker, MD · Answer

"Pinching" in the midline is actually not enough information because if most of the "pinch" is because of the lower skin pulling UP you would falsely assume the upper skin could move lower. In my experience, most well done tummy tucks can't really have the scar lowered meaningfully unless there has been some other meaningful change(s) affecting their skin laxity in the meantime. The only way to know is with an in-person exam by an experienced board certified plastic surgeon.

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