Is it possible to have minimal revision surgery without redoing entire TT and separating abdominal skin again? (photo)

The picture showing where you are experiencing symptoms is helpful. Given that and the description, the goal of your surgery would not be a simple scar revision. Even if it were, it would not be limited to simply removing the scar and closing, since even then, closing without placing undue tension on the skin requires elevating flaps to relieve tension. In your case there is more going on. There should not be an area of focal bulge after a tummy tuck, so that area should be explored if you are going back in for surgery. This could be due to a seroma cavity or an issue with the fascia in this area or other etiology. CT scans are great, but do have limitations. What you describe as painful lumps that feel like internal splinters, this could be an inflammatory response creating scar tissue around the sutures. Sometimes people have reactions to certain sutures, or infections around permanent sutures, and if that were the case these may need to be removed and/or replaced. When there are a variety of symptoms like this years after surgery, the area would need to be reopened to assess and treat any problems that were found, and sometimes in an exploratory surgery no pathology is found, and the symptoms can go unexplained. No surgeon can guarantee the surgery will relieve all of your pain or symptoms, but the goal would be to determine if there was something that was wrong, and if so, address it, in the hope that your pain is decreased and symptoms are lessened, if not resolved. Please be sure to see a board certified plastic surgeon for this, and if you have your old operative note from your prior surgeries, that may be helpful.

hi,  a small revision can be done. removal of a small amount of skin and not undermining all the way up  can be done. pain management can be addressed by a pain medicine specialist. sometimes removing scar tissue resolves the problem.  have a great day.  Dr. C

Of course, anything and everything is possible.  There are no limits to possibility.  As you have in the past, you'll choose what to do for your own body, as you should.  Some select the procedure they want based on their own research, their budget, their available recovery time, and/or other considerations, and embark on consultations until they find a doctor to do the procedure they want.That approach however turns the doctor into a technician, and robs the patient of value they would receive from the far greater cognitive, judgmental, and experiential aspects that professional surgeon-artists offer.Almost anything is possible, fewer approaches to a situation advisable.

Dear xc1,it is hard to tell for sure without an examination. If you are considering a surgery, I would suggest you to 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

Thanks for the question and pictures. The problem you so well presents is common after multiple surgeries. The is likely scar within the flap which is isolated and creating contour irregularities. The correct approach would be to revise the scar but also have subcision of depressed areas performed along with gentle lipo eg. VASER to the high spots. All this is possible to be done assuming the surgeon is experienced in doing so. Good luck. 

Great job with the communication! From your photos it seems that some appropriate liposuction along with scar revision would likely be the best option to meet your goals.

Thank you for your photo. You appear to be a candidate for revision. The old scar can be removed and a new, more symmetric, thin, and lower incision can be used. At the same time, the areas of concern can be evaluated. If you have uneven fat or excess scar tissue causing your abnormalities or discomfort, they can be removed through the same incision. It is difficult to know exactly what is happening from the photo alone so a physical examination or direct examination can be beneficial. Hope this helps!
Johnson C. Lee, MD
Board-Certified Plastic Surgeon
@drjohnsonlee