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

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.

You are right, that scarring such as the one you have posted, can limit the blood supply to the skin of the abdomen. While I think that you would be a candidate for a tummy tuck, I would be very conservative with the amount that I took out and the amount of dissection that I did.

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