I am only 3 weeks post op and I realize I am still swollen but I am concerned that my incision is too high. Also, I was wondering if there is a dog ear on my left side. I am upset and wonder if this scar can be revised if need be. I also included a before picture. I don't understand why my surgeon's pictures showed other incisions to be so much lower than mine and why mine is higher. Also, my BB seems a little off centered. Or is that just me? My surgeon is American Board Certified.
Incision Too High? Dog Ear? (photo)
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Doctor Answers 8
High? Dog Ear?
Sorry for your issues. It is obvious your pre operative visit was a failure to understand the "possible" outcomes as to incision placement and results. But the left dog ear needs removal under local anesthesia.
Is My Tummy Tuck Scar Too High And Do I Have A Dog Ear On The Left Side?
Your tummy tuck scar, especially in the middle, perhaps should have been a tiny bit lower, but all in all, it appears that you have an excellent abdominoplasty. Your belly button appears to be healing very nicely. I believe it will ultimately be small and attractive. The scar iteself, once all the scabs are gone, should be treated with paper tape or silicone sheeting to decrease redness and decrease the chance of a thick, wide scar.
Six months after surgery, lasering of the scar in my practice has led to a thin, and sometimes imperceptible, scar. Surgery does not end at surgery. Surgery ends when you have the best possible scar for your genetics. If the scar is imperceptible, its positioning becomes less important.
With reference to the dog ear on the left side, this may resolve over time, but a tiny bit of liposuction and a small bit of skin and subcutaneous tissue removed under local should cure the problem in about 15 minutes if it is not already resolved within 3 months.
Abdominoplasty or Tummy Tuck- Incisions, Revisions, and Dog Ears
An Abdominoplasty or Tummy tuck is an operation designed to make the stomach area flatter and smaller. Sometimes the design of the operation includes an incision that might end up too high. Sometimes it's the result of too much tension, if the person didn't have a lot of skin to begin with. Like all operations, there are abdominoplasty risks. These include but are not limited to
- Poor scars. This is not just wide or thick scars, but poor position also. Sometimes scars after tummy tucks can end up too high. This can happen if the incision was placed too high or if tension causes it to be pulled up higher. This can be improved after healing has occurred. I have lowered high incisions quite a distance, but this would not be done for some time - probably 6 months.
- Dog Ears. These are puckers on the ends of the incisions. With swelling present, they might just resolve as you heal. Be pastient. Sometimes liposuction or a small revision will be necessary.
- Need for Revision Surgery. Revision is the word for a touch-up or extra surgery to make it better. Revisions can be big or small. Dog ears would be a minor revision, usually done in the office. Bigger revisions like lowering your incision would probably require anesthesia and drainage tubes.
Give the tummy tuck recovery time. See your surgeon for follow-up. It will most likely improve with time. A revision may be necessary.
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Incisional Placement in Tummy Tuck: Options for Consideration
Tummy tuck surgery requires an incision on the lower abdomen to remove excess skin and fat. The photo that you have provided shows that you have only a limited amount of excess skin above the belly button and more excess skin below the belly button. In these cases, a higher scar than ideal is almost predictable. For my patients I offer a choice of either the traditional approach (which you have), or a lower scar with a vertical closure of the belly button site. This latter approach allows the tummy tuck scar to be placed very low, but adds a small vertical scar near the panty line level. In your case, the left side will likely need a revisional procedure once healing is complete to reduce the dog ear and make the right and left sides more symmetric. The good news is that it appears your tummy is quite flat, and once healing progresses, the benefits of the muscle tightening will be visible. Best wishes!
Dogear after surgery
Thanks for your question, I agree you have a small dogear on the left that may improved with time, ask your surgeon about massage or compression here. If it does not resolve, a small revision in the office can correct it. As for your incision position, I agree it appears higher in the middle, but appropriate on the sides.
Incision and dog ear
The height of the scar would depend on how much laxity your skin had. I expect that when the swelling settles down you may feel better about the incision. The dog ear on your left may improve or can be easily revised as well as the lowering of the scar somewhat. Never is the umbilicus exactly in the middle but from these photo's it appears that it may be be slightly to the right. These issues should be frankly discussed with your surgeon.
Incision Too High? Dog Ear?
The incision is higher than some, and there is a small dog ear on the left. The dog ear has a good likelihood of resolving as healing progresses over the next months. I don't see enough landmarks to comment on the navel position. The incision is not going to move. Your questions would be best addressed to your surgeon.
Thank you for your questions, and for the attached photos. Best wishes. Do continue follow up with your surgeon.
Placement of the incision for an abdominoplasty is dependent, to some degree, on your aesthetic goals and your physician's recommendations. I generally favor a low scar as this is more easily hidden and is aesthetically more attractive. However, placement of the scar in a lower location increases the likelihood that you will have a small vertical incision at the site of release of your navel. I also find that creating a gently upward slope to the sides of the incision reduces the frequency of dog ears. Overall, I think time will reveal that you have a good result although you may need to have a small revision of the left side of the incision. Follow up with your surgeon to make sure you achieve the best result possible.
These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.