Dissatisfied with my TT Results- Why is It a Problem to Extend my Incision?

I am currently 1.5 yrs post op from having a Tummy tuck. My plastic surgeon although very kind and highly qualified was very conservative with my tummy tuck. The biggest problem with my TT is the ends, I have excess skin and fat that form a roll over the top of my underwear. I am sure I needed an extended tummy tuck but wasnt advised of it. When seeing him again and asking if he could extend the incision to address the extra skin and hip fat he declined doing so but instead suggested a LBL.

Doctor Answers 9

Extended tummy tuck or body lift

To decide which procedure is better for you depends, to a large extent, on your examination findings. The photos you provided gives us an opportunity to provide you with surgical options. You have to discuss with you plastic surgeon the advantages and disadvantages of each procedure and see before and after photos for each procedure. 

San Diego Plastic Surgeon
5.0 out of 5 stars 15 reviews

?Extending the TT?

I may be in the minority here, but looking at your after photo in the standing position, I am seeing what I would consider to be a nice result. There is skin excess around toward the edges of the incision, but from the photos I see this does not have a visual component--only when you grab the skin is it apparent. I might feel differently if I could see some excess on a side or back view.

The skin will always buckle when you bend forward or sit. You will not likely find a photo of a sitting swimsuit model in which her abdomen is visible. 

If the excess skin bothers you, it certainly can be removed. Depending upon how far around the excess goes, simply extending the incision may not be enough, and extension all the way around your back may well be needed to correct what bothers you. 

As far as the dog ears go, those can be excised under local anesthesia with about an inch extension of the original incision and that would to my eyes be a benefit. I would think hard about the other alternatives.

Best wishes. 

Jourdan Gottlieb, MD
Seattle Plastic Surgeon
4.6 out of 5 stars 45 reviews

Revision Tummy Talk Options?

Thank you for the question and pictures.

Whether you choose to extend the tummy tuck incision or proceed with a lower body lift will depend mainly on your goals. Communicate these goals clearly with your plastic surgeon and understand the limitations of extending the scar only.  If after communicating your goals you feel that the more limited operation will achieve the results you are looking for you should proceed with the “smaller” of the operations (therefore minimizing risks/potential complications).

Best wishes.

Tom J. Pousti, MD, FACS
San Diego Plastic Surgeon
5.0 out of 5 stars 1,488 reviews

Tummy tuck

I think that either option would be reasonable given your appearance in your photos. The difference between extending the tummy tuck or converting it to a body lift is really a matter of degree.  Both procedures will involve lengthening the scars you currently have.  The body lift will involve a scar going all the way around  your back but will also provide more skin tightening than simply extending the tummy tuck.  If you feel,comfortable with your plastic surgeon, I would follow his or her suggestion.

Ronald J. Edelson, MD
San Diego Plastic Surgeon
5.0 out of 5 stars 27 reviews

Skin folds

Dear ChargegirlTM,

 From looking at your post operative pictures, it appears that you have skin folds due to excess fat in the upper and lower abdomen, lower chest, hips and waist. You will benefit from liposuction of these areas. This procedure will thin out  and tighten the skin in a way that will improve dramaticaly  on your condition or totally eliminate it. Talk to your doctor about it or consult with a board crtified plastic surgeons who has significant experience in liposuction. Looking at their before and after  pictures will help you realize who is good at it.

                     Best of luck,

                                               Dr Widder

Shlomo Widder, MD
McLean Plastic Surgeon
4.8 out of 5 stars 124 reviews

Limitations of Tummy Tuck

The results seen in your photos demonstrate the limitations of tummy tuck surgery.  Your skin lacks elasticity (stretch marks are best clue), so skin that is tight while standing will not contract like an elastic when you sit, and thus the roll.  No surgery can overcome the loss of skin elasticity.The roll that extends across your side and back will require an excision completely across your back ("lower body lift" is a misnomer, but the term is applied to this procedure).  If you just have your existing scar extended somewhat, the roll ('dog ear') will simply extend farther across your back and you will be back for further surgery. 

Michael Kreidstein, MD
Toronto Plastic Surgeon
4.6 out of 5 stars 32 reviews

Always chose the incision that gives you the result you want.

Hello, It's hard to know what would have been the ideal surgery for you without the before photos. I always remind my patients that they should choose the incision length that gives you the best result. I suspect that extending the incision around the sides abd onto the back us what would correct the situation you describe. All the best, Dr Remus Repta

Remus Repta, MD
Scottsdale Plastic Surgeon
4.9 out of 5 stars 162 reviews

Lower Body Lift

The problem with your abdominal skin excess is that it extends so far around onto the back that a circumferential Tummy Tuck (LBL) is necessary. It probably should have been done initially as the result you have is pretty predictable with only a standard TT. You will always have a roll when sitting. The best the surgery can do is make it flat when standing. If it was that tight when sitting you would never be able to stand up straight.

Ronald V. DeMars, MD
Portland Plastic Surgeon
5.0 out of 5 stars 27 reviews

Extending the incision

While extending the incision is possible, its important to access the amount of tissue that extends around your back. A thorough examination by a plastic surgeon will give you the best answer. Its not simply how much that can be pinched between your fingers. Also important is the skin quality. Best of luck and thanks for the question.

Raj S. Ambay, MD
Tampa Plastic Surgeon
4.3 out of 5 stars 34 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.