My Plastic Surgeon Wants to Do a Vertical Incision in Addition to a Horizontal Incision- Will It Heal Well? (photo)

My plastic surgeon wants to do a vertical incision in addition to the traditional horizontal incision in order to address a scar from a pyloric stenosis surgery. He said if he does not do a vertical incision also, then he would recommend a much higher horizontal cut because there can be skin death when dealing with a secondary scar. I am concerned about doing a vertical incision in this tummy tuck because I heard they don't heal as well.

Doctor Answers 3

Tummy Tuck Incision?

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Thank you for the question and picture.

Both options that your plastic surgeon offers in regards to the tummy tuck scars are viable options.

If I were you I would simply tell your plastic surgeon to use his best judgment and to place the incision lines whenever he deems best/safest and most likely to avoid complications such as tissue necrosis and/or problems that can occur ( especially given your past surgical history/scar).

Getting you through the surgery and avoiding complications should be the first priority;  picking an appropriate undergarments/swimming suit down the line will hide the resulting tummy tuck scars.

Best wishes.

Tummy tuck with previous scar

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I think your plastic surgeon is right. Your scar is a little long and definitely retracted. I would suggest just the horizontal scar and just have it higher than usual. It will probably still end up a couple of inches below your belly button. But then you wan't have a higher scar which is what you are used to now. i don't think adding a vertical part will help at all with the issue of circulation and will only add a more visible scar. It looks like you have a lot of muscle weakness which, after it is tightened will allow the upper skin to come further down. Good luck.

Vertical Incision and Horizontal Incision

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Veritical incisions are used in  two types of cases where the blood supply is to the skin is in question or the horizontal closure is so tight a small vertical limb must be made to close the incision.  The vertical incision heals well but the scar is visible on the abdomen.

I would perform your abdominoplasty with a horizontal incision if the scars was an old scar and did not completely cross the mid-line.  However, I would limit the amount of "undermining" performed lateral to keep the blood supply to the skin, and I would place the horizontal incision higher than my standard abdominoplasty.

Rondi Kathleen Walker, MD
Washington Facial Plastic Surgeon

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