I Have an Indention in my Tummy Tuck Scar Above my Pubic Area.

Indentations that occur just above the pubic bone following tummy tuck occur for two reasons:

1) The skin around the old belly button gets pulled done toward the pubic bone. This area is usually lacking the same amount of fat that exists elsewhere under the abdominal skin.

2) Too much fat is removed in the area that the "old belly button" skin gets relocated to, and/or this area is not reconstructed adequately. This will leave an indentation once everything heals.

This can all be corrected with fat grafting. However, it is more challenging to repair than most people think.

Indentation in the area you described could be because of several factors, none of which will affect the quality of your tummy tuck.  If the indentation is small, it is certainly worth waiting for the wounds to heal because as you go throught the healing process your wounds will change somewhat and you may find that you don't need anything done in a few months.  If the indentation is very significant and it is obvious that as you heal this will not change, it may make sense to repair this earlier.  First your surgeon will have to determine what the problem is.  A tight suture?  Area that is missing some fat? Something else?  Based on the underlying problem he can fix it for you.  If you are overall happy with your results and your surgeon, be patient and trust your surgeon to take care of you.

Sincerely,

Martin Jugenburg, MD

Without a photo it is hard to be specific but indentations do accur . If there is an irregularity post op and still there it is usually covered. But the surgery center and anesthesia is not. That is the way I d it but it may be different in your area. Time is your advocate for improvement. 6 months sounds good.  Good Luck.

 You have asked a good question, and one that would be easier to answer if there were some photos of the troublesome area to look at. However, I can tell you that scar irregularities are usually easy to fix, but depending on the problem and your plastic surgeon he may want to wait 6-9 months for the scar to mature first before attempting a "fix." 

  Usually, it is as easy as an office procedure performed under local anesthesia only (a shot of lidocaine) and perhaps some fat grafting if there is any depression in the scar.  Most surgeons would not charge any extra for this revision.  If the problem is more severe and requires a more extensive procedure to fix, then this may need the addition of general anesthesia which could come with some more cost.  Regardless of the extent of the revision needed, if there is truly a problem then most surgeons would not charge a surgeon's fee.

  Hope this helps.  Good luck.

Photos would be helpful to determine exactly what your indentation is and the best way(s) to treat it. With that said, waiting at least 6 months before determining whether or not the area will need to be further addressed is quite prudent and appropriate.

Whether or not there will be any charges that you would have to pay would depend on the office policy and agreement that you had with your plastic surgeon. I would venture to say that most plastic surgeons given a situation like yours would perform the revision for free (no surgical fee) though if surgery had to be performed in an outpatient facility (which doesn't sound like your situation), you may be responsible for these expenses.

Yes a fat graft or revision of area can "fix". I would not wait though. As for additional fee it is up to surgeon of record. 

If the scar is indented centrally above the pubic area, it may flatten out over time.  This most likely will be easy to revise if it does not go away. The best time to do it is between 6 months and a year depending on what the cause is and how you heal.  It depends on what your doctor does for the revision and what his or her policies are regarding these types of procedures as to whether you will be charged a fee.

I agree with your surgeon that waiting for revision is a good idea - I usually ask my patients to allow the scar to fully mature and relax (1 year) before considering revisionary surgery.  As for the revision being included in the finances that you have paid depends on the office policy.  

I suspect the area of indentation is where your belly button was cored out and advanced to the incision line - there is not much subcutaneous fat there and thus a small contour defect can be present. The fix is relatively easy and quite good. In terms of payment - all practices are different. Good Luck!

Without photos it is difficult to tell what is going on. I have seen indented tummy tuck scars, particularly just above the pubic area, when Scarpa's fascia layer was not closed (or the closure came undone), and this allowed the skin and tissues more superficial to it to turn in.  It is also possible that the much thinner area from where your old belly button was and which was brought down has caused this thin area to sink in.  In any event, this can be revised, and the revision is not complicated, but it should wait for 6 months or more after your tummy tuck surgery.