Can remaining stretch marks get bigger or worse when skin is pulled tight during a tummy tuck or LBL procedure?

Question

I have several stretch marks on my stomach( some go a little above my umbilicus too), groin area, and flank area. I know I will still have some remaining after a skin removal procedure. Im concerned the remaining marks could get bigger or worse looking when the skin is pulled tight during the skin removal procedure. Could this happen?

J. Timothy Katzen, MD, FACS · Answer

Hi Butterfly4u, Thank you for your question regarding can remaining stretch marks get bigger or worse when skin is pulled tight during a tummy tuck or BBL procedure. It is extremely rare that stretch marks will get worse after a tummy tuck, lower body lift, or BBL. Even though the skin is pulled tightly, it is rare that the skin is pulled so much it will cause for stretch marks to get worse. Indeed, after a tummy tuck or lower body lift, or BBL often the skin which is removed has stretch marks and these stretch marks are eliminated and thrown away. Again, it is extremely rare that stretch marks would appear or reappear after a tummy tuck or 360 circumferential lower body lift.

I specialize in reconstructive plastic surgery after weight loss.  If you have any more questions regarding the lower body lift, 360 circumferential lower body lift, belt lipectomy, belt abdominoplasty, or belt dermolipectomy please contact my office. Since the body lift is a big procedure, please seek an experienced, board certified plastic surgeon with significant experience performing the lower body lift. Do your research.  Make sure they have performed at least 100 circumferential lower body lift surgeries and have the before and after pictures to prove it.  Carefully examine their before and after pictures and check their reviews on RealSelf.   If you cannot find an experienced, lower body lift surgeon in your neighborhood, consider traveling out of state if you must. Sincerely, Dr. Katzen. (“Verified” Plastic Surgeon, certified by the American Board of Plastic Surgery, Fellow of the International Society of Aesthetic Plastic Surgery, American College of Surgery, and International College of Surgery and member of the American Society of Plastic Surgery, American Academy of Cosmetic Surgery and RealSelf Hall of Fame.)

Daniel Barrett, MD · Answer

Dear butterfly4u,
full tummy tuck will remove stretch marks above the belly button and remaining stretch marks will be placed above the incision line. It is unlikely that your remaining stretch marks will increase in size after surgery. 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

Kenneth Hughes, MD · Answer

Hello, thank you for your question. A tummy tuck will effectively remove most stretch marks from the level of your belly button to your pubic area. Any stretch marks higher or above your belly button will typically remain, however they will be in a lower position once the procedure is completed. It is very unusual for patients to develop stretch marks after a tummy tuck. Most often stretch marks on the abdomen after a tummy tuck are from prior to surgery.

Matthew Peters, BSc, MBBS, FRACS (Plast) · Answer

Hello and thank you for your question.
Stretch marks in the region mentioned are usually excised with an abdominoplasty (TT) / lower body lift procedure.  Those outside of the resection zone usually stay as they are however this can be variable; I have seen them become less or more noticeable depending on the angle of skin stretch, and I have seen them cause problems with internal sutures along wound lines. Usually the degree of overall change to your body shape outweighs these small issues however if there are some that you are particularly concerned about you should discuss them with your plastic surgeon.
Best of luck.
Dr Matthew Peters

Richard Zienowicz, MD · Answer

Hello and thank you for your question. Depending on how loose your abdominal skin is determines how much skin will be able to be removed. It can be skin from your pubic area to above your umbilicus is able to be safely excised, while sometimes it is only skin beneath the umbilicus. This depends on your anatomy and your skin. I would expect most of the stretch marks beneath your umbilicus to be cut away with an abdominoplasty, as this is the case for most women seeking the surgery. THe stretch marks in your groin would likely change. If they are on your mons pubis - the area that a bikini normally hides, they may be pulled upward for a tighter contour or cut away at the top. If they are in your bikini line or upper thighs I would expect a modest amount of pull upwards towards the abdomen but not a significant amount. It really depends on where these stretch marks are. If the stretch marks on your flanks are on the sides of your body, the abdominoplasty scar could be elongated to be able to cut away this stretched skin as well. If they are on the back of your body, you would need to have what is called a "belt lipectomy" or "truncal body lift" to cut these away and lift your buttocks if that is a priority for you. In nearly all cases, stretch marks are improved by skin tightening and skin removal surgery. You can likely mimic this by pulling the skin on your lower abdomen and visualizing what happens to the stretch marks. This is similar to what they will look like afterward.I hope that helps. Thank you and good luck.

Scott W. Vann, MD, FACS · Answer

When I do a tummy tuck I almost always get all the skin below the belly button out, so those stretch marks would be gone. Marks that extend slightly above the belly button would be pulled down to the bikini line level. Marks above that would be put on tension and almost always look a lot better than when very relaxed.  good luck.

Bryan Curtis, MD · Answer

During a tummy tuck (abdominoplasty) or lower body lift (LBL) procedure, excess skin is removed, and the remaining skin is pulled tighter to create a smoother and more contoured appearance. While these procedures can significantly improve the appearance of stretch marks by removing the skin where they are located, it's important to understand how stretch marks may behave during and after surgery:
1.	Stretch marks and skin tightening: When the skin is pulled tighter during a tummy tuck or LBL procedure, the tension can affect the appearance of stretch marks. In some cases, the stretch marks may be stretched or flattened along with the surrounding skin, making them less noticeable. However, this depends on the severity and location of the stretch marks, as well as individual factors such as skin elasticity.
2.	Potential for worsening: In some cases, particularly if the stretch marks are severe or if there is a significant amount of tension placed on the skin during surgery, there is a risk that the stretch marks could worsen. This may happen if the skin is overly stretched during the procedure, causing the stretch marks to become more prominent or even tear.
3.	Scar placement: The placement of surgical scars from a tummy tuck or LBL procedure can also influence the appearance of stretch marks. If the surgical incisions are made in areas where stretch marks are present, such as the lower abdomen or flanks, the stretch marks may be partially or completely removed along with the excess skin.
4.	Individual variation: Every person's skin is different, and the way it responds to surgery can vary. Factors such as skin type, elasticity, and the severity of stretch marks can all impact how stretch marks are affected by a tummy tuck or LBL procedure.
5.	Postoperative care: Following your plastic surgeon's postoperative instructions, including proper wound care and scar management, can help optimize healing and minimize the risk of complications or worsening of stretch marks.
Overall, while a tummy tuck or LBL procedure can improve the appearance of stretch marks, there is a possibility that they may be affected during surgery. It's essential to discuss your concerns and expectations with your plastic surgeon before undergoing any procedure to ensure that you have a clear understanding of the potential outcomes.

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