Is my pooch normal 7 months post tummy tuck? Does my scar need revision? Should I let my plastic surgeon do it?

Question

I had a tummy tuck in January 2018. No muscle repair as I had no need for it. My problem was mostly loose skin and some fat deposits. I had good results for about 4 months then progress stopped and no further reduction in the pooch area was evident. My scar, where my old belly button must have been is lost quite unsightly. My ps is willing to fix it all, no charge. All thoughts are much appreciated.

George Marosan, MD · Answer

Thank you for your question and photos. If you didn't want a muscle repair, you actually did not need a tummy tuck. VASER Hi Def Lipo would've created a very nice hourglass figure based on your preop photos. Well, that bridge has been crossed already, and unfortunately you ended up with a very high scar with a small vertical component. Not much contouring of your back was done either.If you were my patient at this point, I would do VASER Hi Def Lipo 360 degrees, fat grafts to the buttocks (very flat in the side view photos) to give you an hourglass figure. The scar can be lowered possibly in another 1-2 years. I personally would seek revision surgery with someone else who actually has a sense of aesthetics and understanding and ability to create a feminine shape. Your surgeon failed to deliver, he/she did a 2D operation instead of a 3D operation. So, it depends what your final goal is; you didn't think you need muscle repair and your surgeon went along with it.  If such results are created by your surgeon, I personally would not subject myself to the "free revision", you need a new operation to reshape your body and try to correct your results. See a board certified plastic surgeon experienced in advanced body sculpting techniques for an in person consultation/evaluation. Good luck.See the enclosed web reference of a patient who had a C-section and did not want a tummy tuck. Underwent VASER Hi Def Lipo instead to reshape her torso.

Raffy Karamanoukian, MD, FACS · Answer

Abdominoplasty scars can be quite complex, ranging from the simple hypertrophic scar to a multiplane inflamed keloid. Pigmentation, discoloration, chronic inflammation, scar visibility can all occur in the short term. We begin each treatment with combination therapy using Yellow broadband BBL, Vbeam, fractional erbium, intralesional IIT, and scar modulation. Start with a combination of Plato's Scar Serum massaged twice daily after one week of epithelialization followed by Luminase/Exfolase. Scar consultation and revision may be recommended.

Best,
Dr. Karamanoukian
Realself100 Surgeon

Best, 
Dr. Karamanoukian
Realself100 Surgeon

Vincent N. Zubowicz, MD · Answer

From the photographs it looks as though there is a significant contour issue of the lower abdomen. It seven months I don't think this can be ascribed to swelling. It looks to me as though some sort a revision is in your future.

Shlomo Widder, MD · Answer

Dear Susan,   Thanks for posting your before and after pictures. With all due respect, after observing your before pictures, indeed you needed a full tummy tuck with muscles tightening. That would have given you a flat stomach with no unattractive  pooch.   It seems that you had just a mini tummy tuck, which is usually sub optimal and eventually patients request full tummy tuck.   Additionally, your scar is very unattractive and it will have to be changed to a 'U'  shape placed in the natural crease of the pubic and groins area.   It will be in your best interest to consult with experienced board certified plastic surgeons who operate in accredited surgery center for your safety. Most importantly, check the before and after pictures of redo tummy tuck in the photo gallery, to make sure that they are numerous, consistent and attractive with flat stomach, nice belly button, narrower waist, improved body posture and low scar.              Best of luck,                             Dr Widder

John LoMonaco, MD, FACS · Answer

The "pooch" may be excess skin, residual swelling, or even a fluid collection. So first, that needs to be sorted out to determine the best treatment.  If it has not gotten better and bothers you, a revision could reduce the excess tissues and make that old BB scar better. Its a fairly common revision and simple to do in many cases.

Daniel Barrett, MD · Answer

Dear susano22,
it is hard to tell for sure without an examination. If you are not satisfied with your scar, then you can consider scar revision surgery. It is best that you visit your plastic surgeon for further assessment. Only after thorough examination you can get proper recommendations and advice.
Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Karol A. Gutowski, MD, FACS · Answer

Based on the pictures, I would do more liposuction on the abdomen and try to lower the horizontal scar by 2 to 3 inches.

L. Dwight Baker, MD (retired) · Answer

Based on these photos alone, you could definitely benefit from a revision, the details and extent of which would require an examination to determine.  I would definitely recommend lowering the transverse scar, revising the previous belly-button scar and correcting the "pooch" as indicated by examination.  I generally recommend waiting one year after the tummy tuck so that the tissues are optimally soft for revision, especially when needing to lower the transverse scar.If you have confidence in your plastic surgeon, by all means, let that surgeon perform your revision.  If such confidence is lacking on your part, by all means have a consultation with another board-certified plastic surgeon who is experienced in abdominoplasty.  Best wishes to you.

Is my pooch normal 7 months post tummy tuck? Does my scar need revision? Should I let my plastic surgeon do it?

Answers (8)

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