Is it normal to look like this when my stomach is relaxed?

Question

I'm 13 month post tuck with muscle repair. I'm so unhappy with my results. I have hypertrophic scarring, a weird ledge above my scar and my stomach stinks out like I'm bloated when relaxed. I was expecting a flat stomach. Another surgeon recommended another full tuck to better my appearance. My original surgeon seems disappointed with my results as well but doesn't think I need lipo. I'm in the process of getting kenalog injections into the scar. I'm looking for honest thoughts on my outcome.

Ronald J. Edelson, MD · Answer

Unfortunately in some cases the skin may stretch out and loose in the months following a tummy tuck.  Thr muscle tightness can also stretch out. A revision can be done to cut out more skin.   the benefit of this would be that scar could be lowered and the vertical segment removed. The scar itself is not unusual for this time post surgery.   The revision should be far easier to recover from than your first tummy tuck.

Pejman Aflaki, MD · Answer

Hello and thank you for your question. Please re-submit your question and send pictures if possible for a better assessment. Best,
Pejman Aflaki, M.D.                                             
Johns
Hopkins-trained double board-certified plastic surgeon

W. John Bull, MD · Answer

It appears that you will need a revision tummy tuck or at least a revision. I believe your scar is high thick and your muscle repair may not be completely repaired. I would need to do a full exam to be certain as to what needs to be done but I know you would benefit from a revision. Before having a second procedure though I would work on your abdominal muscles and make sure to see at least 2 different plastic surgeons comfortable with this type of revision. This an be improved, but hear what the plastic surgeons are recommending before deciding.

Daniel Barrett, MD · Answer

Dear Dmb41,
I understand your concern. However, without a proper assessment it would be difficult to determine what is wrong. Based on your photos, it looks like you have hypertrophic scar which is a bit high and some fat above your scar. It is best that you visit your plastic surgeon for further assessment. Only after thorough examination you can get proper recommendations and advice.
Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Shlomo Widder, MD · Answer

Dear Dm,   Thanks for posting your pictures, though seeing your before pictures would have been helpful too. Sorry for your less than optimal outcome.   From observing your pictures you appear to have muscles laxity, "outy" belly button and high scar at lower abdomen.      If your surgeon does not recommend redo tummy tuck at this stage, consider consultation with other experienced board certified plastic surgeons who operate in accredited surgery center for your safety. Most importantly, check the before and after pictures of redo tummy tuck in the photo gallery, to make sure that they are numerous, consistent and attractive with flat stomach, nice belly button, narrow waists, improved body posture and low scar. Check also the reviews for patients' good experience.                             Best of luck,                             Dr Widder

Thomas Trevisani, MD · Answer

The structure of the abdominal wall has many components. A full aggressive tummy tuck including muscle repair addresses most of these components. It is essential that the pre-op consultation address whether or not a completely flat abdomen can be expected. Often times, the internal organs push outward and are enhanced by loose lower rectus muscle. The ledge you see above your scar is a combination of possibly a little extra skin and fat plus swelling ( which can only be determined at your in person exam)- and may subside with more time.

Charles Nduka, MD · Answer

A thorough in person examination would be needed before any surgical option can be given. The best course of action would be to schedule an appointment with a board certified plastic surgeon for an in person consultation and a detailed discussion of your surgical options.

Richard Mark Winters, MD · Answer

you are clearly a relatively thin person who didn’t have quite enough skin to give you a low incision or avoid a vertical scar.... what’s troubling you worse is that your intra-abdominal contents seem to have outmatched the integrity of your abdominal wall leaving you with a protruding tummy despite a ‘muscle repair.’You are definitely a candidate for a revision BUT you will have to make some concessions.... in order to lower your incision, you will require an extension of your vertical incision from your belly button to the transverse incision....in addition, you will require mesh (outside your abdomen so not like what you read about with pelvic mesh) in order to keep your tummy from bulgingGood luck....

Adolfo Sesto, MD · Answer

Hello. No it's not normal. First of all, you need to exercise your abdominal muscles, and after that you are a good candidate for a full Tummy Tuck again, since your results are not good enough. Please see some cases in the video below.28 year experience
American Society of Plastic Surgeons
International Society of Aesthetic Plastic Surgery
International Society of Plastic Aesthetic and Reconstructive Surgery
Dominican Society of Plastic and Reconstructive Surgery

Arian Mowlavi, MD, FACS (license on probation) · Answer

Hi, thank you for your question. Unfortunately, there are no pictures to make a good assessment. However, if you are unsatisfied with your previous operation then a tummy tuck to fix the previous mistakes may be recommended. High definition VASER liposuction is the X factor in this procedure. It is used to creat a pleasing aesthetic and amazing abdominal contour. The most important part is finding an experienced surgeon. A Skype or FaceTime consultation with a specialist will help you get an accurate recommendation and pricing.
Respectfully, 
Arian Mowlavi MD, FACS
Realself 100 Hall of Fame Inductee

Is it normal to look like this when my stomach is relaxed?

Answers (11)

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