I had a full TT with muscle repair. I have a scar running hip to hip, around the belly button and an inch right below the bb. My PS said that there was not enough skin to pull down and that if not for the vertical incision, my scar would be much higher on my stomach. When I'm standing up, I'm very flat and I don't have much skin to pinch. When I bend over 90 degrees, i have a big roll and my skin wrinkles. PS said it's lack of skin elasticity. Has enough skin been removed?
How Do I Know Enough if Excess Skin Has Been Removed from my Tummy Tuck?
Doctor Answers 4
Reasonable result after tummy tuck will still have loose skin with bending
There are many reasons for this. TYpically loss of elasticity that is seen with age, sun exposure, massive weight gain/loss, pregnancy may be more noticeable when you bend over or sit down and will not always be eradicated with a tummy tuck alone
Tummy Tucks do not correct problems with loss of elasticity.
Tummy Tucks do not correct problems with loss of elasticity of the abdominal skin. The goal of the operation is to remove excess inelastic skin and to tighten the abdominal wall musculature, which creates a flatter contoured abdomen. The skin roll that you are describing is most likely related to this loss of elasticity Over stretching the skin can contribute to an increase in this condition not enough can result in an unsatisfactory result.
In my experience, post operative abdominal compression may improve the contour of this inelastic skin to some extent, however some visual laxity is certainly expected when bending 90 degrees in such cases.
Questions about tummy tucks
What concerns me about your posting is that an experienced plastic surgeon who has done lots of tummy tucks should almost never be surprised by what they find during surgery and require modifications they hadn't predicted for you before surgery. This kind of intraoperative change of plan should very rarely happen in experienced hands.
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Amount of skin removed after Tummy tuck
First of all, it is normal to bend over and have some skin excess, even after tummy tuck surgery. Otherwise you wouldn't be able to stand up straight without some serious tension on your incision. As far as a vertical limb closure, if things can't be closed easily without tension at the time of surgery, this approach may be required. This can be predicted ahead of time in susceptible individuals with only mild skin excess, therefore there are no surprises. I agree, that a low position of the abdominal scar is desired. If I end up with a vertical limb at the time of surgery (which is rare), it is usually at the bottom midline, and can be removed and revised later, after the skin has healed well and is relaxed to allow a primary tension-free closure.