Why do I have those 2 indentations on each side of my abdomen above my incision? (Photo)

Abdominoplasty treats the skin excess and muscle weakness of the abdomen, as well as any fat that is between the belly button and the pubic hairline. Liposuction treats only fat. It can be used to thin out the abdomen, but the skin must be in good condition with no excess, and there should not be muscle weakness. I do not like to combine abdominoplasty with liposuction because of the added risks of fluid collection under the skin, VTE and wound healing problems.





Aggressive liposuction with tummy tuck is dangerous.  A full tummy tuck with liposuction at the same time will certainly put you at a high risk for fluid under the tummy tuck skin (seroma). A full tummy tuck with aggressive liposuction at the same time will also certainly put you at an unacceptably high risk for a potentially fatal pulmonary embolism (PE), venous thromboembolic event (VTE). The literature is complete with this information. The science is the science. This is a risky combination.





The incidence of seroma formation is about 16.0 percent in the abdominoplasty-alone group and 31.2 percent in the abdominoplasty with liposuction group.





The combination of abdominoplasty and liposuction procedures can still overwhelm the body's ability to resist these shear forces by the fact that more surface area is available to “shear” and thus produce seroma fluid. Not so much as an additive effect but synergistically, such that the seroma fluid from the flanks flows into the adjacent abdominal space and resists the ability of the upper abdominal flap to close over the abdominal wall. Patients must be counseled about their risk for seroma formation and treatments aimed at resolving them including frequent postoperative visits for needle drainage and the rare case requiring operative drainage in the face of a persistent seroma.

Minor temporary surface irregularities are common and usually will smooth out over several more weeks to months. The redness appears to be superficial irritation.Close follow up with your plastic surgeon is recommended. 

the pleating of the skin is common after TT. It will settle over the period of a couple of months, but it does take time. Not sure about the burning sensation, best to ask your surgeon while he is examining you post-op.

Thank you for sharing your question and photographs and congratulations on your tummy tuck procedure.  The indentations appear to be skin pleating from surgery that has some irritation present, likely from compression garment use.  This skin pleating does resolve with time as will the tight, firm sensations of your abdomen and the swelling that can create a pressure like sensation. 

Thank you for your question. It is not unusual happen this sometimes because of pull. Usually they smoothen around 3-4 months. Please follow instructions from your PS and revaluate in 3 months.

THe tethered pulled look can occur after a tummy tuck as the upper flap is brought down to the lower flap. It often softens with time.  Best to give it a 6 months to a year.

Hi PatuskaI will assume you are talking about the lines on either side of your belly button, and further that the liposuction was limited to the flanks.Given those assumptions, my guess is that these lines are due to the pull of sutures.  It is very likely that this will improve over then next year or so as you heal.  Of course, only your doctor can tell you for sure so be sure to discuss with him.Best to you.Sek

Thank for you question and for posting your photos. Your tummy tuck looks great for this stage. Ladies (and occasionally men) often get some 'ruching' in the first few weeks after tummy tuck and it almost always settles. If you are one of the few for whom it doesn't settle then I'm sure your plastic surgeon will offer you a minor scar revision, usually in the office under local anaesthetic. In the meantime we always advise our patients to wear their Lycra garments as much as possible (take it off to shower) and ask your doctor about scar massage. It looks like you will have a lovely tummy. Congratulations

Congratulations on having undergone the tummy tuck procedure; based on your photographs, I think that your plastic surgeon has a very nice job for you (your photographs demonstrate a very good early outcome).  Your plastic surgeon will be in the best position to explain exactly what the "folded skin" is related to;  I have seen these types of indentations result (temporarily) from stitches placed between the abdominal wall flap and the the abdominal wall fascia (progressive tension relieving sutures). Best wishes for an outcome that you will be very pleased with long-term.

Hello and thank you for your question. It would be important to know exactly how your tummy tuck was performed in order to accurately determine what could be causing the irregularities. Without knowing what was done the irregularities may be sites where too much liposuction was performed. If your surgeon used progressive tension sutures and a drainless technique it may be points where the skin was sutured down to the abdominal wall. If that is the case, the area may improve when the sutures dissolve. There are many other possibilities but an explanation from your surgeon would be best. I would discuss your concerns with your surgeon who can advise you. Best Wishes

Theodore T. Nyame MD 

Harvard Trained Plastic Surgeon