Mini Tummy Tuck for Stretch Marks and Piercing Scar?

You have very good questions and concerns.Skin can retain much of it's elasticity or it can be stretched and have lost the ability to retract. We see this loss of elasticity after considerable weight gain then loss or often after pregnancy, as in your case. The telltale signs of lax skin are stretch marks (stria). Simply put, these stria are tears in the deeper layer of the skin called the dermis. Unfortunately, these do not resolve by themselves. If there are a lot of stretch marks and the skin is loose, then there are few options other than to remove the excess skin. Unfortunately from the photograph you sent, there is little in the way of excess skin so a mini tummy tuck would only remove a small portion of the stretch marks and would extend the scar further. You would be left a bigger, possibly worse scar and essentially the same stretch marks. With respect to the scarring, there are many factors can affect the ultimate quality of the scar. Individuals who demonstrated poor scarring in the past and those with a family history of suboptimal scarring should be considered high risk for developing unsightly scars. Another very significant factor in determining how a wound will scar is how the wound was initially created. Surgical wounds that have been carefully created are likely to heal with less scarring than a traumatic wound with considerable tissue injury and irregular borders. Unfortunately, you seem to have propensity to develop thick (hypertrophic) scars. This is mostly in your genetic makeup and is not going to change. You should think very, very carefully before agreeing to any additional surgery.There are numerous techniques and preparations touted to decrease or limit scarring, but only a few have been scientifically shown to have any real benefit. Moisturizing lotions should be applied frequently to all scars. It is critical to avoid significant sun exposure, as this can lead to hyper-pigmented and prominent scars. The use of tape or steri-strips to relieve tension on the wound has been found to be helpful. There has been some evidence to suggest that silicone sheeting, or liquid preparations containing silicone, can enhance the appearance of scars if used early and often in the healing process. Steroid injections can soften and flatten very thick, hypertrophic scars and keloids. Pressure dressings have long been used in burn victims with good clinical results and remain an important adjunct. Finally, time alone will result in considerable improvement in most scars. I recommend you use a silicone product for the fresh scar and leave the belly button scar alone. I sympathize with your situation. It is a very difficult one but one with few, if any, good options. BRK

A tummy talk would remove excess skin and fat from the lower abdomen. It will allow the abdominal muscles below the belly button to be tightened. A mini tummy tuck does not have a separate incision around the umbilicus, thus a mini tummy tuck alone would not change the piercing scar.A full tummy tuck uses a second incision around the umbilicus to undermine the skin off of the abdominal wall up to the ribs. This allows more skin to be removed from the lower abdomen, compared to the mini tummy tuck. Also, the abdominal muscles above and below the belly button can be tightened with a full abdominoplasty. Given the fact that this creates an incision around the belly button, a scar revision could be performed at the same time.

It’s unusual to perform an
abdominoplasty on a women who is only twenty years of age and has only one
child.  This procedure should be
delayed until women are done having children.  It’s not a procedure that can be frequently repeated over
and over again.

Assuming you’re done having
children there are several issues that should be addressed.  Your pictures suggest that you have
redundant abdominal skin with stretch marks, weakened abdominal muscles, a
lower abdominal C-section scar and scarring associated with an umbilical
piercing.

Without the ability to perform a
physical examination, it’s hard to make a specific recommendation.  It would appear that a mini
abdominoplasty would not meet your aesthetic expectations for several
reasons.  This procedure would not
tighten the upper abdominal muscles or address the excess skin in this
region.  In addition the piercing
scars and some of the stretch marks would still be present.

For these reasons a better option
might be a full abdominoplasty with a lower vertical scar.  This would be necessary to address the
piercing scar in the presence of a low C- section scar.

It’s important to discuss all these
issues with your plastic surgeon. 
There’s probably no perfect solution for your problem and no matter what is decided you need to be a participant in the
decision.