What will stop me getting flat, seamless tummy tuck results without overhang above scar? (Photo)

Hello Lucian0,

Thank you for your question regarding achieving a flat, seamless result without overhang above the tummy tuck scar.

Evaluating Your Concerns:

Based on your before photo, your main concern is avoiding any overhang or flab above the tummy tuck (TT) scar. Achieving a smooth, tight transition with no overhang is indeed possible, but it requires careful planning and the right surgical techniques.

Factors to Consider:

Skin Elasticity and Amount of Excess Skin:

The amount of excess skin you have and the elasticity of your skin are critical factors. If you have significant excess skin, a more extensive excision may be necessary to achieve a flat result.
Liposuction:

Liposuction of the flanks (sides) and possibly the upper abdomen is essential to create a smooth contour. This helps in eliminating fat pockets that could cause bulges or unevenness.
Muscle Repair:

During a tummy tuck, repairing the abdominal muscles (diastasis recti) is vital. This repair helps flatten the abdominal wall and supports a tighter appearance.
Recommendations:

Full Tummy Tuck with Muscle Repair:

Ensure that your tummy tuck includes muscle repair (if necessary) to address any separation of the abdominal muscles. This repair is crucial for achieving a flat, tight abdomen.
Comprehensive Liposuction:

I recommend considering VASER liposuction in addition to traditional liposuction. VASER lipo uses ultrasound technology to break down fat more effectively, allowing for smoother contouring and better skin retraction. This can significantly enhance the overall result and minimize the risk of overhang above the scar.
Extended Incision:

Sometimes, an extended incision (lower on the abdomen) may be necessary to remove more skin and fat, ensuring a smoother transition and minimizing overhang. Discuss this option with your surgeon.
Post-Surgical Care:

Post-surgical care, including wearing compression garments and following your surgeon’s instructions, is crucial for optimal healing and achieving the desired results. Compression garments help reduce swelling and support the new contours of your body.
Conclusion:

Based on your photos and concerns, you are a good candidate for a tummy tuck combined with VASER liposuction. This combination will likely give you the flat, tight results you desire without overhang above the scar. Ensure you discuss all these options with your plastic surgeon to tailor the procedure to your specific needs and achieve the best possible outcome.

Good luck, and I hope I’ve answered your question regarding achieving seamless tummy tuck results without overhang.

Sincerely,

J. Timothy Katzen, MD, FASMBS, FICS
Plastic Surgeon

In the photos, there is thick subcutaneous fat which gives the 'overhang' when contrasted with the fixed abdominoplasty scar.   Avoiding this is usually possible but depends on the technique used, and the starting anatomy.  This degree of overhang is unusual; most surgeons can achieve a smoother transition.

Thanks for the question and photos.
There is not a simple answer to this question!  Your body shape prior to surgery.  Post surgery weight gain or loss.  Scar contracture.  But... .the overwhelming factor in achieving the flat seamless abdomen you desire is the technique and experience of the surgeon.  Having excess fat in the central and upper abdomen is a known problem with traditional abdominoplasty surgery.  Newer techniques such as abdominoplasty with SAFE liposuction have improved this tremendously.  We are now able to safely remove much of the excess fat in the central portion of the abdomen (and flanks).  This helps achieve the flat appearance you are looking for.
Best wishes! 

Please be advised that a raised, red, inflamed incision (what you describe as overhang) may be part of the temporary healing process. The flatness of your result depends on many factors (overall skin excess, skin quality, age, habits, several intrinsic factors - genetics- etc). Also the amount of visceral (intra abdominal fat). It will be easier to obtain more information and have a better idea of the result you are expecting after a thorough consultation with your surgeon.