Tummy tuck with preexisting scar from pyloric stenosis? (Photo)

It does appear that you would be a good standard abdominoplasty candidate. You scar will be in a much lower position on your abdomen. Due to the poor blood supply through old scar tissue, you will be at a slightly higher risk factor for wound breakdown in this area postoperatively. I would watch this site very close to assure good blood flow and address any healing concerns.

Thank you for your question regarding whether you can have a tummy tuck with a preexisting scar from pyloric stenosis. Many articles in the plastic surgery literature have examined this condition. You can have a tummy tuck with a pyloric stenosis scar. In addition, patients can have tummy tucks with open cholecyst or gall bladder scars. Therefore, you are a good candidate for a standard tummy tuck and do not have a fleur de lis or vertical abdominoplasty. Therefore, I would continue the standard tummy tuck. Good luck; I hope this helps answer your question about whether you can have a standard tummy tuck with a preexisting scar from pyloric stenosis.
If you have any more questions regarding reconstructive surgery after massive weight loss, please contact my office. Reconstructive surgeries after massive weight loss include an abdominoplasty, tummy tuck, thigh lift, breast lift, mastopexy, arm lift, brachioplasty, torsoplasty, back lift, buttock augmentation, and buttock lift. Since these reconstructive surgeries after massive weight loss, are big procedures, please seek an experienced, board certified plastic surgeon with significant experience performing these types of lifts. Do your research. Make sure they have performed at least 100 of each procedure you are considering for reconstructive surgery after massive weight loss. Make sure they have the before and after pictures to prove it. Carefully examine their before and after pictures and check their reviews on RealSelf.

In my opinion, these types of horizontal scars would be the type to cause issues with wound healing following abdominoplasty procedures. The horizontal scars will interrupt the remaining blood supply to the lower abdomen if left in place. It is possible that it could be excised with a fleur de lis abdominoplasty, however this would be a very wide scar for a fleur de lis and would be unlikely to get all of the scar out. In the end, however, only an in person physical exam will determine your suitability for this procedure.

The existing scar will likely cause some compromise to the blood supply, placing you at slightly greater risks for wound healing problems. It appears that the scar has been there for a while. This would allow your tissues to partially revascularize and reduce the risks. Your photos suggest that a standard abdominoplasty would be adequate and your can avoid the extra vertical scar from a flur de lis procedure. Your plastic surgeon can provide the best answer for you as he or she has had the advantage of physically examining you. If you are not completely comfortable you can still get another consultation for a second opinion.

Hi 121521,
Your scar is concerning.
During a tummy tuck, the lower abdominal excess (usually from belly button to pubic hairline) is removed. The resulting gap is closed in two ways: 1. undermining the remaining upper abdominal skin to the costal margin (lower rib edges) and 2. sitting you up in bed to allow top and bottom incision lines to meet.
After undermining, the remaining upper abdominal skin is attached only on its upper edge--and in your case, 25% or so of that attachment has previously been divided--while blood supply may have grown across the scar, it may not be as robust as before your pyloric stenosis repair. In addition, this tissue may not stretch down as easily as the adjacent tissue.
I have done DIEP surgery (similar removal, different purpose) in patients with mirror image right upper quadrant scars from gallbladder surgery--and good wound healing is possible. But those patients scars (and presumably your scar as well) would be vertically higher than most.
A good exam of your tissue and its ability to stretch is essential--in that vein, I would defer to the plastic surgeon who examined you.
Hope this helps.
Best,Christopher Pannucci MD MSBoard Certified Plastic SurgeonPlastic Surgery NorthwestSpokane, Washington

Hello and thank you for your question.
Based on your photo, you appear to be a good candidate for a traditional tummy tuck which would allow to remove the excess skin below the belly button and to tighten the recuts (abs) muscle in order to achieve a flat abdominal contour. You may be a candidate for a mini tummy tuck to limit the extent of the incision, however, it's difficult to tell based only on the photos.
Whenever you have pre-existing scars in upper abdomen, that predisposes the lower portion of abdominal skin to higher risk of wound healing complications.
I would recommend to obtain an in person consultation with a Board-Certified Plastic Surgeon to further discuss your options, concerns and expectations.
I hope this helps.
Best,Dr. Karanetz
Dr. Irena KaranetzBreast Fellowship-TrainedBoard Certified Plastic Surgeon

Dear 121521,
based on your photos, you look like a good candidate for a TT. Full tummy tuck should tighten your abdominal muscles and remove the excess skin. Flanks liposuction would give you a better shape. I would suggest you to consult a board-certified plastic surgeon because 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

Hello and thank you for posting. I do not think there is a big risk of blood supply. I have done tummy tucks with this kind of scar before. As long as the surgeon isn’t overly aggressive with skin dissection for the muscle repair access and skin excision and avoids liposuction in that area the overall blood supply should not be an issue.

Oh and by the way… you do not need a Flour de Liz Tummy Tuck!

Best of luck,
Dr. Miguel Mota.

I have performed tummy tucks in patients with a large gallbladder scar even larger than your scar. I’ve never had a problem with blood supply. Your scar is smaller and higher up so the blood supply should be fine

You should do well as long as your surgeon stays below the old scar. A standard tummy tuck should work well for you.