What are my best options for tummy tuck revision? (Photo)

Question

My vertical scar ended up much higher than discussed and did not heal well. I am also unhappy with my belly button and was hoping the scar would be more hidden. My surgeon was very defensive and made me uncomfortable discussing revision.He said if I wanted the vertical lowered I would need a mini tummy tuck, but that he would be willing to revise the vertical scar. I would like a second opinion on options. If the scar could be lowered an inch I’d be happy. Can my bellybutton be redone? Thank you

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

Carmina Cardenas, MD · Answer

In anatomy there are not normal or abnormal, just different. 
Your preop belly button position is very high on your abdomen for that reason you needed the vertical incision. 
Massage both the vertical and horizontal incisions in order to make softer the scars and that will help to lower your TT scar. I consider after one year postop your scar may be ready to lower the position and shorten the vertical. 
Definitely belly button may be revised, it will just end up with a little lollipop pop incision to reduce de diameter of the belly button and hide the scar. 
Be encouraged. 
Dr. Cárdenas

Daniel Barrett, MD · Answer

Dear Sarah1516,
I understand your concern. However, without a proper assessment, it would be difficult to determine what went wrong. It is best that you visit your plastic surgeon for further assessment or ask for a second opinion. Only after a 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

Camille Cash, MD · Answer

It is best to wait a year from your surgery before considering scar revision.  If you have waited that long it does appear you are a candidate for this procedure.  If you are not comfortable with your surgeon, see another board certified plastic surgeon near you for a consultation.

Connie Hiers, MD, FACS · Answer

If you have some excess skin, then the vertical scar could remove decreased. However, if the skin is still tight, I would do micro-needling for now.

Mats Hagstrom, MD (license on probation) · Answer

The vertical scar was inevitable in order to have a low set scar. It is in my opinion, the correct decision, and a better way to do the procedure. Having a high scar would be a worse outcome. For individuals who have only moderate skin laxity and a have a high said belly button it’s not possible to have a low set scar and avoid the vertical incision 
Your plastic surgeon is correct that any attempt at lowering the scar would require adding an additional mini tummy tuck. It would most likely put a lot of tension on your lower abdomen, and may pull up on your scar to some degree.
Getting a natural looking belly button is one of the hardest parts of a tummy tuck procedure. I tell patients to judge Tammy, Taka Resort, specifically based on first and foremost, who gets the most natural looking belly buttons with a very low sets car that follows a anatomic contours naturally and evenly on both sides. 
Some patients have great anatomy, which makes creating the new belly button appearance easier than others. In particular individuals, who have deep belly buttons have an advantage in this regard 
To me, your result shows evidence of somebody who is talented, and I would say your result is well above average.
The number of patients who don’t have a surgical looking belly button after a tummy tuck is a pretty small minority.
Patience best shot at getting a quality belly button appearance is during the primary procedure. Revisions usually do not improve belly buttons significantly and I think you’re Surgeon did a nice job with it.
I’ve seen better, but I’ve seen many many which are far worse than yours.Skin incisions take 12 to 18 months before they are mature. I suggest you give this at least a year and a half before contemplating having a Revision.
Revision surgery, especially scar revision are only indicated when something could be performed better during the second operation. Your doctor did everything correctly, so redoing the scar is not indicated because the chance of it healing better from simply revising it is unlikely.
I generally recommend patients have multiple in person, consultations before scheduling any permanent and irreversible cosmetic surgical procedure. during consultations patients, should I ask providers to open up their portfolio and show you their entire collection of before, and after pictures of previous patients who have similar body characteristics to your own.
This is the time to review what results in the hands of each provider looks like, and ideally an experience provider should have a sufficient number of before, and after pictures to be able to identify and show lots of examples of previous patients who had similar body characteristics. This would’ve been the time to be critical of your surgeon’s outcomes in regards to what belly buttons, or the central abdomen looks like.
 There’s no correct number of consultations to have defined the right provider. I suggest patients start the process by having at least five in person consultations before scheduling surgery. By doing that, you can educate yourself in regards to what typical results look like between each provider and get familiarized with what quality results should look like and who gets the best results on a regular basis.
An experience provider should have no difficulty showing you at least 50 previous patients before and after pictures. Being shown a handful of pre-selected images, representing the best results of a providers career is insufficient to get a clear understanding of what average results look like in the hands of each provider.
Again, Judge tummy tuck results based on who gets the most natural looking belly button, with a very low set scar that follows, anatomic contours, naturally and evenly on both sides. The torso should look balanced, attractive and natural from all angles, including from the sides, and from behind.
I would encourage you to hold off on revision surgery until you are at least 18 months out from surgery 
Best,
Mats Hagstrom, MD

What are my best options for tummy tuck revision? (Photo)

Answers (6)

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