Revision tummy tuck over skin graft for a better appearance? (Photos)

Hello Jane Lewis, thank you for your question regarding revision tummy tuck options after a skin graft. I appreciate you sharing your history and pictures, and I’m sorry for the complications you’ve experienced. There are a few options available to improve the appearance of the grafted area and achieve a more aesthetically pleasing result.

One approach is serial excisions. This involves making an incision in the existing scar just above the pubic region and gradually removing sections of excess skin and fat in a horizontally oriented elliptical pattern. Since a large excision may not be possible in a single surgery, multiple procedures—typically three to four—may be required. The final stage would focus on reconstructing a more natural and aesthetically pleasing belly button.

Another option, though more complex, involves the use of tissue expanders. Tissue expanders are balloon-like devices that are placed under the skin and slowly inflated over time, allowing the skin to stretch and create additional tissue. This process mimics the way skin expands naturally during pregnancy. Once the skin is sufficiently stretched, the expanders are removed, and the newly created tissue is used to reconstruct the lower abdomen. This method requires multiple office visits for gradual inflation and could take several months to complete. Additionally, during the expansion process, the area may appear distended, which is an important consideration.

Both options have advantages and challenges, and the best approach will depend on your specific case, skin quality, and healing capacity. I highly recommend consulting with an experienced, board-certified plastic surgeon specializing in revision tummy tuck surgery to determine the most effective plan for your needs.

Best of luck, and I hope this information helps!

Sincerely,
Dr. Katzen

Hi there,
Sorry to hear about your unfortunate complication after tummy tuck, happy you are fully healed.
A revision tummy tuck can help however you will likely need tissue expanders placed in your upper abdomen for a few months beforehand. Tissue expanders are small balloons placed under the skin and injected with saline every few weeks. This causes the skin over top the expander to stretch. After the stretch is complete the expanders can be removed and a tummy tuck performed to removed most of the skin graft.
This is a tough procedure and may require multiple revisions. I would seek a university hospital where they train residents/future doctors. These programs usually have reduced cosmetic fees and you will be worked on by multiple MDS.
All the best

You'll need to lose a lot of weight, possibly 10 kg or more, to reduce the excess fat on the INSIDE of your abdomen, an area we can't liposuction. Once that has occured a revision tummy tuck can be performed to remove the graft and give you a normal contour to your abdomen. The caveat is the scar will be an inverted T shape, with the vertical portion reaching your belly button.

Tissue expanders can be used to stretch your normal skin and give more skin to remove the graft. This may take two or four total procedures, but the graft can be removed. Please go visit with a reconstructive plastic surgeon. Perhaps your insurance might assist with this.

Wow! I'm so sorry to see and hear about what you went through! That is horrible!
Fortunately, I do believe this can be made better. Not perfect, but better. Normally, I try to put the Tummy Tuck scar as low as possible so it is hidden under skimpy bikinis. Unfortunately, you are going to have a scar up to your belly button. It appears that the skin of your upper abdomen and sides is pretty tight. Weight loss may help relax this so that it can be pulled down to cover the missing tissue. It can likely be pulled down a little at your current weight, which would help reduce the defect, but not close it.
It also appears that your pubic skin remains rather loose. This can easily be pulled up, maybe even all of the way to your belly button or at least close, allowing my to entirely close the wound/defect!

This however, would leave you with pubic hair up to your bellybutton. Fortunately, this is an easy fix for this! Laser hair removal.

Good Luck to you!

Regretful that you had to experience such on favorable outcome. But there are solutions which may require 2 to 3 different procedures to be done over several months to years.The simplest thing to do is to remove the central part of the skin graft by simply cutting it out and closing the rest of the wound letting the surrounding the skin to relax for at least another six months to a year make another visit to the operating room removing additional for the skin graft and bringing your own natural skin slowly together over the course of several different visits to the operating room (commonly know as "serial excision". Another option is to place tissue expanders (balloons) underneath the skin on the sides of your abdomen to expand the skin overtime by putting fluid in these balloons and then cutting the skin graft in the middle and bringing the edges of the newly grown skin together, but that's a much more complicated option. I guess the good news is you do have choices to enhance the appearance but the trade-off is additional surgeries. Good luck and thanks for the question1

Your situation is complex and I don’t think we can give you an accurate assessment based on pictures alone.
Most likely the great majority of skin laxity or excess abdominal skin was removed during the tummy tuck so they’re probably isn’t all that much skin to cover removing the skin graft.
it may be possible to remove part of it, but whether this will overall be an improvement or not is another question.To get an assessment, and better understanding of what can or cannot be accomplished you really need in person consultations.
It would also be important to have a very clear, understanding a risk factors, and why you developed the tissue necrosis from the first procedure.
Thermal injuries are not typical after a tummy tuck.
Was this from using a heating pad after surgery? If so, it would be the second time I’ve seen that complication.
You may want to see if there’s a verified burn unit in your area and talk to the plastic surgeons who do burn reconstruction since that is the type of work you need.
For this type of work, partial improvements are usually the best we can hope for.
Best,
Mats Hagstrom, MD