How can I flatten out my stomach after an exploratory laparotomy? Will scar revision surgery help remove the butt shape? (Photos

Question

In September i had to have an emergency surgery to patch up my colon. The surgery in my opinion destroyed my stomach. Due to the vertical incision, the scar is slightly depressed and causes my stomach to look like a butt. My lower abdomen on both sides are very poofy and pouch like that are slightly tender. I was told it was my fat and muscles. I also had a pelvic fracture and noticed that my v cut is way different on both sides. I do wear an abdominal binder and started doing an workouts.

Francis Johns, MD · Answer

Thank you for your question.Based on the photos you posted, I would suggest liposuction and possible scar revision. I would suggest an in person evaluation to determine if you have any muscle separation which would also need corrected. That can not be determined by photos.

Richard G. Reish, MD, FACS · Answer

Hello and thank you for your question.  The
best advice you can receive is from an in-person consultation.  Based on
your photographs and extent of your major previous surgery, you may benefit from a surgical scar revision 6-9 months after your initial surgery.   Make sure you specifically look
at before and after pictures of real patients who have had this surgery
performed by your surgeon and evaluate their results.   The most
important aspect is to find a surgeon you are comfortable with. I recommend
that you seek consultation with a qualified board-certified plastic surgeon who
can evaluate you in person.
Best wishes and good luck.
Richard G. Reish, M.D.  FACS
Harvard-trained plastic surgeon

Nelson Castillo, MD · Answer

Thank you for sharing your question and photographs.  Your indented scar is likely a result of scar tethering which can be improved with a scar revision 6-12 months after your surgery.  This allows your tissues to soften and fully heal, leading to a more predictable outcome.  If you have sufficient laxity, you may also be a tummy tuck candidate to minimize the amount of vertical scar present.  See an ASPS board certified plastic surgeon in consultation for the best advice.

Ayman Hakki, MD · Answer

Scar revisions sometimes (not always) improve scars, but they rarely change your shape. I suspect you will need a full tummy tuck with lipo of the love handles and a possible fat transfer to give you the shape you desire. May 2018 would be the time to have this done, not earlier. See a board certified plastic surgeon who does a ton of combined procedures, operates at a certified facility and ask her, or him; how many of this surgery did you do (on patients like me) last year Dr.? Do not settle for vague answers and ask to speak to a recent patient who had a similar surgery. All surgeries carry risks and disappointment with you scar is one of them. Good luck, do your homework, don't be in a hurry, and choose your surgeon and procedure carefully.

Tania Medina de Garcia, MD · Answer

Hello Dear.Thanks for your question and provided information as well.It is hard to give you an answer without an in person evaluation. However my recommendation is to wait at least 6 months and after that period of time you can have a scar revision or discuss with a plastic surgeon the best options for you based on your goals.Good Luck.

Steven Wallach, MD · Answer

You are probably best to wait at least 6 months or so for the tissues to soften first. A scar revision or tummy tuck  may be helpful at that point.

Adolfo Sesto, MD · Answer

Thanks for your photos. Sorry for your emergency surgery, but it kept you alive.Your abdomen can be flatten by a Tummy Tuck with an incision called Fleur de Liz ( the Boy Scout Symbol). Thru this incision  abdominal muscles will be tighten and scarring tissue and excess skin will be remove. But you most wait at least 9 month after your laparotomy.You seem to have a queloidal scarring tissue, I suggest the use of Triamcinolone Acetonide at 1% ointment, rubbing it twice a day just in the scar, to help.Member of the AMerican Society of Plastic Suregeons (ASPS)

Samir Shureih, MD · Answer

Based on the pictures posted, the abdominal contour after exploratory laparotomy is probably due to fat and adherence of the scar to the abdominal wall. in person examination for proper diagnosis is needed. You are too early after surgery to recommend any further surgery now.Continue your abdominal wall strengthening exercises and re-evaluate in few months.

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