I recently got a laparotomy in Nov of 2024. Am I a candidate for a tummy tuck? Would the scar be taken away? (photo)

Question

If so would the scar be taken away?

J. Timothy Katzen, MD, FACS · Answer

Hello, and thank you for your question regarding whether a tummy tuck can remove your laparotomy scar. First, thank you for your history and your pictures. Based on your photos, you have keloid scars above your belly button and a laparotomy scar below the belly button. While it’s difficult to tell from the images, it does not appear that your lower scar exhibits the same hypertrophic or keloid characteristics as the upper scar. However, given your history, you are at high risk for keloid formation, meaning your tummy tuck incision could also develop keloid scarring.

A standard tummy tuck removes excess skin and fat from the mons pubis (pubic region) to just above the belly button. This typically removes about a quarter of an inch of skin above the belly button, which would not be enough to fully eliminate your laparotomy scar. If your goal is to completely remove the laparotomy scar, a modified approach may be necessary.

One alternative is a low reverse tummy tuck, where instead of making the incision very low in the pubic region, the incision is placed just above your laparotomy scar. This allows the entire area containing the laparotomy scar to be excised, and the remaining skin is pulled down to the lower abdomen. The downside of this approach is that your tummy tuck scar will sit higher than a traditional tummy tuck scar, possibly above your beltline.

If you proceed with any type of tummy tuck, it's important to be aware that you are at high risk for keloid development, which could affect the final scar appearance. To help minimize scarring, consider using silicone sheets or silicone-based creams after surgery, and if keloids develop, steroid injections (Kenalog or 5-FU) can help flatten and lighten them.

I hope this helps answer your question regarding whether a tummy tuck can remove your laparotomy scar. I recommend consulting with an experienced, board-certified plastic surgeon who specializes in post-surgical scar revisions and body contouring. If you have any further questions, please reach out to a qualified plastic surgeon for a detailed evaluation and discussion of the best surgical plan for your goals.

Sincerely, Dr. Katzen, MD, MBA, FACS, FICS.

Daniel Barrett, MD · Answer

Dear watermelon6913,

6 months should be enough to fully recover. A tummy tuck will not remove your scar completely. If you are considering surgery, I would suggest you consult a board-certified plastic surgeon. Only after a thorough examination, you will get more information and recommendations.

Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Robert M. Lowen, MD · Answer

Not sure if you need a tummy tuck or liposuction with a scar revision. As you know scars are permanent unless you could remove all the skin up to the top of the scar. That's not possible.
   So if you did a  tummy tuck you would still have that vertical scar and only a certain amount of the lower scar would be removed as the abdominal flaps is pulled down and the excess removed.
  There is also increased risk of skin necrosis at the lower midline where the vertical  scar meets the abdominoplasty transverse incision.  This is because the scar cuts off some circulation.  
   An option would be to do liposuction to get a thinner skin contour.  There would likely be some skin laxity that could be put to use by removing the old scar and bring the sides together.
A year later when all healed, a limited undermining tummy tuck could be done, and some rectus plication to improve abdominal wall laxity.
     Midline scars on the abdomen tend to heal with hypertrophy; revising them recreates the original scar.  However, in the revision, the suture or staple marks can be removed. If  sutures are left over seven days they will leave scars.  So the incision closure should be engineered with deep layer support so that superficial skin sutures can be removed in seven days, or a subcuticular pull out suture should be used.

Morad Askari, MD, MBA · Answer

Thank you for your question. You might be a candidate for a tummy tuck after a laparotomy, but the final decision depends on an in-person consultation to assess your healing progress, overall health, and the location of the laparotomy scar. Regarding whether the scar can be removed, the scar below the belly button can be removed, while the scar above may remain but can flatten or shift with the skin tightening. Your surgeon can assess your scar location and abdominal wall in person to determine if you're a good candidate and whether your scar can be excised during surgery.

Emily C. Wirtz, MD · Answer

Hi watermelon6319, assuming you have healed fully from your laparotomy, and that you have obtained a form of clearance from the surgeon who performed your procedure, you may be a candidate for abdominoplasty surgery. It’s important that the original condition has been fully treated or is stabilized, and that you are back to your baseline health before putting your body through another demanding surgery. Skin removal with abdominoplasty can remove a significant portion of the scar in the photographs, but you may still be left with a short vertical scar right above the pubic area.

Larry C. Leverett, MD, FACS · Answer

I cannot tell if you are a good candidate or not because I don't know your medical circumstances, your BMI (ideally 29 or less), your smoking status, your expectations, or your ability to take a couple weeks off. Addressing only the image submitted, the procedure that address the abdominal contour and scar would be an abdominoplasty +/- liposuction of the abdomen and flanks. The midline scar, however, is quite high and some of the top portion of the scar would likely remain.

Earl Stephenson, Jr., MD, DDS, MBA · Answer

Dear Watermelon

Thank you for your pictures. Via your pictures it appears that you may be a candidate for a tummy tuck. The best way to determine that with an in person consultation. In order to be considered for a tummy tuck you must be in good health no significant medical problems, he must have excess skin, a modest amount of excess fat, and most importantly laxity of your tummy wall muscles. As it pertains to your vertical scar. The scar that's below your current belly button would be removed the scar that is above. Your belly button just moved to a new position below your belly button. If you to have that scar surgically removed then you would add an additional scar to the traditional incision. Meaning that you would end up with an upside down "T" scar most likely all below your belly button.
I hope this helps.

Best wishes,

Earl Stephenson, Jr, MD, DDS, MBA

ESJ Aesthetics

Matthew S. Kilgo, MD · Answer

Hello and thank you for your question. Without a physical examination, it is difficult to answer your question with certainty. However, based on your photographs, an abdominoplasty would likely remove the portion of the scar from the belly button down to the pubic region. The remainder of the scar would  most likely be relocated to lower abdomen to form a "T" scar at mid portion of your abdominoplasty incision. It may be possible to revise that scar to make it more favorable in appearance. It is also important that you be thoroughly evaluated for any underlying hernias along the scar. As always, you should consult with a plastic surgeon certified by the American Board of Plastic Surgery for best results. Good luck.

Daniel Careaga, MD · Answer

An exploratory laparotomy is an operation that is usually life-saving. Traumas, infections and cancer can all cause serious abdominal conditions and the “ex-lap” is the generic name for any operation to address whatever potential issues may be inside the abdomen. The downside to ex-laps however, is the resulting scarred as seen in your pictures. pictures they’re definitely has some loose skin to be able to remove most of the scar, but I would say it would be unlikely to be able to remove the entire scar because it does extent fairly high above the belly button. Having said that, I would say it still worthwhile to remove as much of the scar as possible, and I would recommend doing a scar revision of whatever remaining scar is present to improve the appearance of the scar. Before commencing down that road, I would most likely recommend getting a CT scan of the abdomen to make sure that there is no hernia presence that would need to be repaired.

Jeffrey M. Darrow, MD · Answer

Thank you for your photographs.  Knowledge about your overall health, your BMI being 30 or less and a physical examination to determine how much loose skin you have on your lower abdomen would help to determine whether you are a good candidate for a tummy tuck.  As your previous scar from your laparotomy extends well above your belly button, it likely would not be removed at the time of your tummy tuck. In addition, this should be considered, your previous scar shows evidence of being hypertrophic, and your tummy tuck scar would likely also be hypertrophic, ie raised and hyperpigmented.  This should be discussed in detail with your plastic surgeon. Best wishes.

I recently got a laparotomy in Nov of 2024. Am I a candidate for a tummy tuck? Would the scar be taken away? (photo)

Answers (19)

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