Wrinkled Skin After Mini Tummy Tuck and Liposuction

Question

I had surgery 8 1/2 weeks ago (2/13/09): mini Tummy Tuck with muscle repair (hernia) and Liposuction. The surgeon did not use drains. I started out 118 lbs, 5'6", 28 years old. My surgeon said that there is a "50/50" chance the wrinkles will go away. The surgeon did not move my belly button.  I am really concerned about the way I look. I expected to have a nice, smooth, flat tummy after surgery. My side view also still shows a bulge.

Bram Kaufman, MD · Answer

I am sorry to see you are having concerns.I recommend to patients that they wait at least 3 months, possibly 6 months before assessing for a final result. If it is obvious that the result is suboptimal then revision is indicated. The advantage of revising after 3 months or more is that the inflammation from the original surgery has resolved completely and the revision is easier, more reliable and more likely to provide the best result. Your surgeon obviously feels that revision might be a very real need. If this comes to pass, then a full abdominoplasty is the best option. I hope this answers your question sufficiently.

J. Timothy Katzen, MD, FACS · Answer

Hi SilliGirl,

I'm sorry to hear about your concerns following your mini tummy tuck and liposuction. Based on the issues you've described with wrinkled skin and a persistent bulge, it sounds like a full tummy tuck might be necessary to achieve the smooth, flat tummy you desire. The wrinkles you're observing are likely excess skin rather than excess fat, which is something a mini tummy tuck may not adequately address, especially if there was significant skin laxity to begin with.

The absence of drains in your initial surgery is not likely the cause of the wrinkled appearance. However, it's possible that the area was over-liposuctioned, leaving you with additional excess skin. A full tummy tuck can remove this excess skin and tighten the abdominal area more effectively than a mini tummy tuck, particularly if there's a significant amount of skin laxity and a need for more comprehensive muscle repair beyond what was initially done for the hernia.

I understand this might not be the news you were hoping for, especially after undergoing a surgical procedure with the expectation of a certain outcome. It's important to have a thorough discussion with a board-certified plastic surgeon who can assess your situation in detail and provide you with the best options moving forward. A full tummy tuck involves a more extensive procedure but has the potential to correct these issues and give you the results you were initially seeking.

Sincerely,

Dr. J. Timothy Katzen, MD, FASMBS, FICS
Plastic and Aesthetic Surgeon

Leila Kasrai, MD, FRCSC · Answer

I haven’t seen your before surgery photos, but I think you may have benefited more from a full tummy tuck than a mini one. This is because of how much loose skin is present, which is currently contributing to your skin laxity and wrinkling. Even though it can take several months for the true results of your surgery to appear, I don’t think that the wrinkling you see now will really disappear. A revision tummy tuck may be necessary.

Richard J. Bruneteau, MD · Answer

The vast majority of patients who
have redundant abdominal wall tissue require a full abdominoplasty.  When patients have minor amounts of
loose lower abdominal skin, mini abdominoplasty is appropriate, but these
situations are not common.

It appears that you continue to
have residual redundant upper abdominal skin, weakened abdominal muscles and
stretch marks.  Your photos suggest
that you would benefit from conversion of your mini abdominoplasty to a full
abdominoplasty with umbilical transposition.  At this point, conservative management
is unlikely to impact your abdomen.

It’s important to discuss these
issues with your surgeon and obtain a second opinion if necessary.

Christopher J. Morea, MD · Answer

I understand why you are disappointed with your results.  Unfortunately, you appear to have been a better candidate for a full tummy tuck rather than a mini tummy tuck.  I see many patients in my practice every year who desire a flat tummy following pregnancy and childbirth , but they do not want the larger incision associated with a full tummy tuck.  It is important the realize that the mini tummy tuck only delivers a good result in a very small percent of the population.  A full tummy tuck would have removed most of your stretch marks and lowered the others possibly below your swimsuit line.  Your abdomen and muscle would be tighter and you would have the results I'm sure you wanted initially.My advice would be to consult another plastic surgeon who is board certified and obtain another opinion regarding how to achieve the results you desire.Best of luck,

Thomas A. Mustoe, MD, FACS · Answer

You have reason to be concerned. In general, after 8 ½ weeks most of the swelling has resolved. If you still have wrinkles, they may not go away on their own. Unfortunately, mini tummy tucks allow for removal of only a limited amount of skin. If there was considerable skin excess before surgery, a full abdominoplasty might have been recommended. You should discuss a time table for revision with your surgeon. Don't expect gradual improvement to continue after 3 or 4 months.

Rigo J. Mendoza, MD · Answer

Thank you for your question. Based on your picture, it looks like you had excess skin and stretch marks that extended above the umbilicus. Therefore, a mini tummy tuck was probably not your best option. A full tummy tuck would have gotten rid of all the loose skin and most of the stretch marks. Could have done a full muscle repair done as well. This would have given you a flat abdomen.

Jose M. Soler-Baillo, MD, MS · Answer

Scar placement a great looking belly button and superior liposculpture are the keys to a successful tummy tuck. Lots of patients opt for mini surgery and end up with mini results. Don't lose hope. You can still get the results you want.

Scott C. Sattler, MD, FACS · Answer

You clearly have residual skin laxity above the belly button. It also appears that your surgeon moved your upper abdominal tissues toward the midline during closure- and this results in vertical wrinkles that usually smooth out with time. Bottom line- you needed a full tummy tuck but opted for the mini TT. No reason why you ould not have a full TT in a few months and vastly improve your results. You have a very nive figure hiding under all of the loose tummy skin.

Otto Joseph Placik, MD · Answer

It is difficult to say at this point because skin typically takes a minimum of 4 months to contract.
However, based on your current appearance and your relatively low set umbilicus, it is my impression and opinion that you could have an excellent result with a full tummy tuck.

Wrinkled Skin After Mini Tummy Tuck and Liposuction

Answers (20)

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