Hello Caring269962, Thank you for your question would you still be a candidate for a tummy tuck after having a liver resection? Thank you for your history and your pictures. First, we should analyze your picture to determine the best procedures. You have cutis pleonasmus (excess skin), striae (stretch marks), and dermatocholosis (loose skin) of the abdomen with a vertical midline supraumbilical scar and right mid-abdominal oblique scar from your liver resection. Yes, you can undergo a tummy tuck or abdominoplasty. However, the tummy tuck needs to be modified due to blood supply. Typically, the blood supply to the area below the belly button and above the pubic region comes from several arteries that originate from the back and travel over the hip. On the right side, the liver section scar has cut off this blood supply. Therefore, the pattern of the tummy tuck needs to be seriously considered. Most experienced plastic surgeons have dealt with scars from liver sections before. In addition, they’ve dealt with open cholecystectomy, or gallbladder, scars higher up in the right upper quadrant. These patients have undergone successful tummy tucks. For patients with scars like yours, a modified reverse tummy tuck needs to be performed. During the modified reverse tummy tuck, an incision is made several millimeters above your prior oblique liver resection scar. The scar would be made from one hip to the other hip. Dissection would be done, taken downwards towards the belly button and the pubic region. The inferior abdominal wall would be exposed from the pubic region to the liver resection scar. Then, tissue dissection will be carried out underneath the flap towards the sternum. Having mobilized the tissues, the upper abdominal flap can then be mobilized and pulled down towards the pubic region. Then the rectus abdominis muscles can be plicated. With the soft tissue dissection, as well as the muscle plication, the procedure will allow the anterior abdominal flap to be mobilized inferiorly towards the pubic region, and then excess skin and fat from below the liver resection scar to the pubic region can safely be resected. The vertical scar may need slight revision but should not hamper the blood flow to the central abdominal area. You will not have as much skin and fat removed as a traditional abdominoplasty, or tummy tuck. However, you should be able to obtain a much flatter result for me with this modified top-down approach. Basically it’s a reverse tummy tuck with the initial incision placed above the liver resection scar. However, the final position of the tummy tuck scar will be significantly lower on your abdomen. Bottom line, you can have a tummy tuck after a liver resection, with a scar, as depicted in your picture. Most plastic surgeons offer free virtual or in-office physical consultations. Therefore, explore what other plastic surgeons have to say. Good luck. I hope that I have answered your question regarding would you still be a candidate for a tummy tuck after having a liver resection. If you have any more questions regarding tummy tucks, abdominoplasties, or abdominal liposuction, contact an experienced plastic surgeon. Since the tummy tuck surgery is a big procedure, please seek an experienced, board-certified plastic surgeon with significant experience in performing tummy tucks. Do your research. If you cannot find an experienced tummy tuck plastic surgeon in your neighborhood, consider traveling out of state. Sincerely, Dr. Katzen, MD, MBA, FACS, FICS (Plastic Surgeon, President of the American Society of Bariatric Surgeons, certified by the American Board of Plastic Surgery, Fellow of the International Society of Aesthetic Plastic Surgery, American College of Surgery, and International College of Surgery and member of the American Society of Plastic Surgery, American Academy of Cosmetic Surgery, RealSelf Hall of Fame, and RealSelf Doctor Advisory Board for Medical Review and Consumer Panel.)
