Loose skin after tummy tuck - what is going on? (Photo)

Question

I got a tummy tuck/bbl at the end of 2022, only recently have I discovered this line above my belly button that is specifically noticeable when I sit down. It was never there before the surgery and was not there last summer. It's not an incision mark or scar, its loose and soft. I have stayed within 10 pounds of the weight I was when I got the surgery. I am so confused as to why this has happened. What is going on?

J. Timothy Katzen, MD, FACS · Answer

Hello Ariel,
Thank you for your question regarding the loose vertical skin above your bellybutton following your tummy tuck, and for sharing your pictures and medical history. It's important to address your concerns accurately to achieve the best outcome.
From your description and the provided images, the issue appears to involve scar tissue rather than loose skin. Here's a closer look at your options:
Physical Examination: A thorough physical examination by a plastic surgeon is crucial. This will help differentiate whether the issue is indeed scar tissue or if it is residual loose skin that might have not been adequately addressed or has changed post-surgery.
Surgical Removal of Scar: If the issue is determined to be scar tissue, one option is surgical removal of the scar. This procedure would involve excising the old scar and suturing the area, which would result in a new, potentially less noticeable scar.
Consideration of Previous Liposuction: Another possibility to consider is whether liposuction was performed in the midline area during your tummy tuck. Over-suctioning in this area could lead to uneven contours or indentations.
Fat Transfer: If the area has been affected by previous liposuction, fat grafting (fat transfer) might be an effective solution. This procedure involves harvesting fat from another area of your body and injecting it into the problematic area to correct the contour and add volume.
Choosing a Specialist: When dealing with issues related to previous surgeries, especially for something as specialized as a revision tummy tuck, it's essential to consult with a board-certified plastic surgeon who has extensive experience in body contouring and revision procedures.
Your next step should be to revisit your original plastic surgeon or seek a second opinion from another qualified surgeon to discuss these options. They can provide personalized advice based on a detailed examination of your current condition and the surgical history.
Understanding the underlying issue and exploring all possible treatment options will be key to achieving a satisfactory outcome. Make sure your concerns are thoroughly addressed during your consultation.
Good luck with your next steps, and I hope you achieve the results you are looking for.
Sincerely,
Dr. Katzen

Morad Askari, MD, MBA · Answer

Thank you for your question. Over time, the skin may lose its elasticity, especially after significant weight loss or gain, during pregnancy, or after surgical procedures. Even if you've maintained your weight within a 10-pound range, skin laxity can be affected by age and genetics. Also, in some cases, the development of scar tissue can lead to changes in the skin's texture and appearance, particularly near incision sites. It's important to schedule an appointment with your surgeon to discuss your concerns. They may examine the area above your belly button to determine the cause of the loose skin. Be sure to provide details about when you first noticed the issue and how it has progressed.

Igor Burko, MD · Answer

Hello, my name is Igor Burko, and I am a Plastic Surgeon at SY Aesthetics in NYC. It is difficult to say what that is exactly without seeing it physically in person. However, the skin will continue to stretch over time due to gravity and can change with any weight alterations. I think it is best you speak with a trained Plastic Surgeon who can give you their best recommendation during a consultation.

Daniel Barrett, MD · Answer

Dear Tasteful965525,
I understand your concern. However, without a proper assessment, it would be difficult to determine what is wrong. It is best that you visit your plastic surgeon for further assessment or ask for a second opinion. Only after a thorough examination, you can get proper recommendations and advice.
Daniel Barrett, MDCertified, American Board of Plastic SurgeryMember, American Society of Plastic SurgeryMember, American Society of Aesthetic Plastic Surgery

Stanley Okoro, MD · Answer

Thank you so much for your questions and the photos you provided. I would consider building collagen and elastin to the skin of your upper abdomen so you love your results! The cutting edge technology to do this is with Bodytite and Morpheus. This skin tightening modality uses Radiofrequency heat to promote tighter skin in the area. If this is the only area you would like to correct, this procedure can easily be performed under oral sedation with little to no down time. Make sure you consult with a board-certified plastic surgeon. Good luck!

Robert M. Wald, Jr., MD · Answer

This is quite unusual. It's hard to say exactly what's going on without preoperative photos. Sometimes, if there is loose skin above the belly button prior to surgery, this can be stretched and cause this problem. I would suggest you see your surgeon to go over this concern.

David Hill, MD · Answer

Liposuction often happens at several layers, especially when lipocontouring or highlighting of muscle groups is done. Sometimes when superficial liposuction is done, trauma to the skin results in the skin having less elasticity or some irregularity. It looks like the surgeon may have done some sculpting of the midline to emphasize your natural contours, which may have cause a bit more noticeable laxity here. There are some laser treatments and also some biostimulators which can increase collagen and elastin and may help with the appearance.

Michele A. Shermak, MD · Answer

Hello! I would recommend you return to your plastic surgeon who performed your surgery. They know best the technique performed and can consider a fix. If that is not convenient, then consider visiting with a board certified plastic surgeon near you. You can find one at plasticsurgery.org. A small fix under local may work.
Best of luck to you!

Ulas Bali, MD · Answer

Since you have totaly heal from your surgery after 2 years. And it seems you have excessive skin even you do not have fat it might happen to have extra skin. You can undergo a surgery that removes extra skin and provides your desired look

Connie Hiers, MD, FACS · Answer

You probably lost some weight and now have a little loose skin. Perhaps you improved your diet and have less internal swelling. Minimally invasive skin tightening like Renuvion or BodyTite can be done to tighten this area.

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