Planning to do a hysterectomy and tummy tuck at in July. Do I have enough skin to do a full tummy tuck with a low scar?

Question

Planning to do a hysterectomy and tummy tuck at the same time, I had a couple of consult...two think that I'm not a candidate for a full tummy tuck the others think that lipo of flanks, muscles repair and a short scar TT will work for me, I'm confused is that possible? To get a flat tummy with just a mini TT? Other Doctor thinks that full tummy tuck with a vertical scar is best. Please help. My surgery is in July.mi also had a C-section.

Richard G. Schwartz, MD · Answer

Based on your photos, I don't think you need a full tummy tuck as your skin doesn't look that loose.  If your C-section scar is objectionable and uneven, then I suggest a mini-tummy tuck to include scar removal, extensive liposuction of abdominal wall and flanks, and even muscle tightening (plication) if examination reveals any muscle looseness.  It all depends on what your examination shows.   This can be safely done in combination with a hysterectomy.

Nelson Castillo, MD · Answer

Thank you for your question and for sharing your photograph.  Ultimately the decision on the right procedure depends on what goal appearance you would like to obtain and what your physical exam shows about your abdominal skin excess and underlying muscle laxity.  At first glance you appear to have minimal excess skin and rather just some excess adipose tissue which may be amenable to liposuction alone.  If you have muscle separation or when laying down have significant skin excess a skin removal procedure like a tummy tuck or mini tummy tuck would be a better option.

John Michael Thomassen, MD · Answer

You seem to have little excess skin and more an issue of excess adiposity.  I would recommend liposuction.  You do have a slight rectus diastasis but to undergo a tummy tuck to correct this would be a bit overkill in my opinion.  You will have a large scar and even a vertical scar if your umbilical keyhole cannot be entirely removed.  Best wishes, Dr. T.

Luis E. Redondo, MD · Answer

You dont have enough skin for a full tummy tuck, so My recommendation would be to remove that c-section scar with a mini tummy tuck, also to give you access to the abdominal cavity for the hysterectomy combined with a really good liposuction. Best of luck,

Vasdev Rai, MD · Answer

Scar needs to be placed based on available excess skin. Thus decision can only be made by your own surgeon at time of actual physical exam.  Guess work is a wrong way to find it. See your surgeon again.

Jeffrey K. Scott, MD · Answer

Thank you for your question, this is an issue which comes up commonly when considering an abdominoplasty. Obviously an actual physical examination is needed to better answer your question.This exam would reveal whether or not the rectus muscle seperation extends above the belly button, the amount of intra-abdominal visceral fatty tissue present, the degree of skin laxity during forward flexion and how high or low the belly button is located. In my opinion if the rectus muscle separation extends above the belly button, a full tummy tuck would provide a more flat/tight abdomen. In your case I would guess that a full tummy tuck would also result in a short vertical scar within you lower abdomen due to the skin not being overly lax and the belly button located relatively high. However in most cases this vertical scar can be resected and re-sutured along your low horizontal bikini line scar after the skin relaxes in several months. As you have now learned there are several ways to approach a tummy such as yours. You have been given several options and all of these are very reasonable ones. Ultimately choose a  Surgeon certified by the American Board  of Plastic Surgery who you trust and whose recomendations make the most sense to you. Best of luck!

Leonard Tachmes, MD · Answer

Thank you for your question! Without full physical examination it's difficult to say for certain but by the look of your photos your biggest issue may be excess fat as opposed to excess skin. Consult with several board certified plastic surgeons in person to see what may be the best option for you.

Darryl J. Blinski, MD · Answer

Based upon the posted photos I think you are NOT a great candidate for full low scar TT. Yes you may need the vertical extension incision. Best to see a few more boarded PSs ASAP.

Derby Sang Caputo, MD · Answer

Probably you have enough sagging skin for full TT.   I dont think a Mini TT will do the job here.  Perhaps a vertical scar will be the answer. Your photos give us an idea but you have to make an evaluation in person to determine if you can or not have a full TT.

Michael M. Omidi, MD, FACS · Answer

Dear Amar,It appears that you have some laxity and would be be able to have a full tummy tuck, although it is difficult to completely assess with just the pictures.  I usually have patients sit down and lean forward.  This helps determine how much loose skin you have.  A mini tummy tuck addresses only the lower half of the abdomen.  I do not suggest a vertical scar for you. Best of luck, Dr. Michael Omidi An in-person exam with a board-certified plastic surgeon is the best way to assess your needs and provide true medical advice.

Planning to do a hysterectomy and tummy tuck at in July. Do I have enough skin to do a full tummy tuck with a low scar?

Answers (10)

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