Will my tummy tuck scar drop lower when swelling goes down or can it be lowered? Was there a way to place the incision lower?

Question

I had a tummy tuck 5 days ago, same time of my tissue expander exchange from my mastectomy. I had excess skin and stretch marks above and below my belly button from my pregnancies. I am small framed and thin, and my muscles didn't need to be cut. I only have one vertical incision but it's not low enough. It is NOT low enough to be covered in my low cut underwear. Will in drop a bit when the swelling goes down? Can it be fixed at some point?

Michele A. Shermak, MD · Answer

Hello! Incision placement needs at least 6 weeks to get an idea of where the scar will be. Earlier than this the surgery is really fresh and the torso is swollen, bandages are present - this all throws the eye off.Scars may be modified but that is not typically done prior to 6 months. Good luck!

Christian Subbio, MD · Answer

So much of this depends upon how much tissue you had prior to the surgery, and even how low your "low-cut "underwear is.  There are limits to how low eschar can be placed depending upon the amount of skin present prior to the procedure.  I wouldn't expect it to drop at all with time.  Lowering eschar which is too high is a very difficult thing to do.Best of luck!
Dr. SubbioBoard-Certified Plastic SurgeonNewtown Square/Philadelphia, PA

Cory S. Goldberg, BSc, MD, FRCS(C) · Answer

Placement of the incision with a tummy tuck is one of the first and most difficult decisions to make for a surgeon. Placing the incision lower and closer down to the pubic hairline is cosmetically better, but has some disadvantages. The lower the incision the more difficult it is to bring the upper edge of the skin down to meet the incision line. If the incision is placed too low, the surgeon could be in the position where they are not able to close the incision line, and this result in a need for a vertical scar or additional scar on the abdomen.
  
Your surgeon likely placed the incision in the best place possible, though that might not have been in the lowest possible spot. It could potentially be lowered secondarily, but this would require another operation of course, and could result in worse scarring.

Joanne Lopes, MD · Answer

It is difficult to determine how high or low your scar is from your tummy tuck without a photo . It is always advisable to speak  with your  plastic surgeon regarding your surgery and scar placement . Typically the scar is usually positioned  below your panty or bikini line . That is difficult to do if you wear a string bikini or very low and scanty panty . Sometimes a small vertical scar in the midline ( where the belly button was previously) is needed to keep the scar low .

Brian A. Pinsky, MD, FACS · Answer

Thank you for your question.  It is difficult to tell without seeing pictures.  Generally, the incision for an abdominoplasty is deigned low enough to sit in the underwear line. There is typically not a vertical component to the scar unless there was a pre-existing scar from prior surgery, or a small vertical scar was needed to keep the transverse scar low. Scars will take 9-12 months or longer to matures, and a small vertical scar may heal very well and not be noticed even in a low cut bathing suit.  The scar position should not change significantly, but it is important to allow proper healing time to assess the final result.  Be sure to follow up with your surgeon to address these concerns. Be patient and good luck!  Scars can always be revised.

Douglas Taranow, DO, FACOS · Answer

Thanks for your question.It is rare that an abdominoplasty incision lowers after the procedure.  You must wait 6-12 months before even considering a revision.  Photos would help in evaluating you and giving accurate advise.Best of luck with your continued recovery.Dr T

Brian Coan, MD, FACS · Answer

Congratulations on your recent surgery and thank you for sharing your question about your post operative recovery and results after your surgery.  Final results can take 6-12 months for all the swelling to subside.  At our office here at CARE we actually see all of our surgery patients the very next day after surgery and then again at two weeks and beyond. We enjoy staying closely connected to our patients and enjoy giving the extra attention and service. Your concerns are important to discuss directly with your board certified plastic surgeon.  He or she will appreciate the open communication and will want to help you. I hope this is helpful and wish you all the very best.  Sincerely, Brian S. Coan, MD, FACS

Ven Erella, MD · Answer

Thank you for your question. without seeing pictures hard to comment. Your incision is unlikely going to lower in general after surgery. I recommend you wait few months and re evaluate if it need to be lowered. At this stage too early to comment. Please talk to your PS

Bernabe Vazquez, MD · Answer

First off,I I assume you mean you have a Horizontal Incision not a vertical one. Unless you have a horizontal incision with a small vertical "T" at the center?? Either way, 5 days is extremely early and you are sure to get some skin relaxation and the scar may come down a little. Regardless, anytime after 6 months a  scar revision can be done under local anesthesia and then the scar can be brought down a few centimeters usually.Hang in there for now, its still very early.

Steven Wallach, MD · Answer

Your incision will likely not lower much after surgery.  If you feel it is too high, you might be able to revise it in about a year or so.

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