Am I the only one in world with past surgery scars and unable to have anything done?

Question

Had a mini tummy tuck over 10 years ago. Wanted full TT. Had an ex lap then open abdominal surgery to repair gallbladder duct over 30 years ago, left with large scar across upper abdomen. Mini tuck done no issues with healing. Now I’m told I am unable to have tummy tuck because of large abdominal scar and blood flow healing issues. Also told couldn’t have liposuction either. Am I the only one in world with past surgery scars and unable to have anything done?

J. Timothy Katzen, MD, FACS · Answer

Thank you for sharing your concerns regarding the possibility of a full tummy tuck and liposuction following your previous abdominal surgeries and mini tummy tuck. As a plastic surgeon, I understand your desire to further enhance your abdominal contour.

The presence of a large scar from your previous gallbladder duct surgery, as well as the mini tummy tuck, could potentially pose challenges when considering a full tummy tuck or liposuction. The primary concern in such cases is the preservation of blood supply to the abdominal skin, which is crucial for proper healing. In some instances, extensive scarring may disrupt the normal blood flow and increase the risk of complications, such as delayed healing or tissue necrosis.

However, it's important to note that each patient's situation is unique, and different surgeons may have varying opinions on the feasibility of performing a full tummy tuck or liposuction in your case. It may be helpful to seek a second or third opinion from other board-certified plastic surgeons who have experience with complex cases involving significant scarring.

Rest assured, you are not the only one facing such challenges, and there may be alternative options available to help you achieve your desired outcome. By consulting with experienced plastic surgeons, you can explore the most appropriate and safe approach tailored to your specific needs and medical history.

I wish you the best of luck. Please seek to consult with a board-certified plastic surgeon.

Sincerely,
Dr. Katzen

Rodger Shortt, FRCSC · Answer

Cosmetic surgery is generally very safe.  However, even a skilled surgeon will have complications from time to time.

In patients that have a lot of scars on their abdomen, tummy tucks can be far more difficult.  There are a few real issues: one is the diminished blood supply as the previous incisions cut some blood vessels used to perfuse the skin.  Another is scarring that prevents pulling the surrounding skin tight, giving a less ideal cosmetic outcome.  It is also possible to have hernia's through old scars making liposuction more risky; care to investigate that prior to liposuction is important.

Dr Rodger Shortt, plastic surgeon in Oakville, Ontario.

With all that said, many people with past surgery can safely undergo cosmetic surgery.  If a surgeon cautions against surgery, patients should take their concerns seriously.  With that said, a second opinion is always an option.

Christopher Pannucci, MD, MS · Answer

Hi suprwmn72,
Any surgeon considering tummy tuck will talk about your past surgical history--and yours sounds extensive.
Based on your description, you probably have a subcostal scar on the right (oblique, paralleling the lower ribs, and just below the ribs), plus a vertical midline scar from the ex lap, plus a low left-to-right scar from the mini tummy tuck.
A full tummy tuck requires that the abdominal skin and fat be undermined to the level of the lower ribs. For your right side, this would mean that all blood supply passes either through one of your two (subcostal or midline) scars, or through the narrow band of uninjured/never had surgery skin on your lower right flank.
A tummy tuck with that scar pattern puts you at high risk of skin death and a big open wound.
I promise that you are not alone...part of being a good plastic surgeon is having good judgement, and I too have turned patients away if they are at high risk of wound healing complications.
Hope this helps.
Best,Christopher Pannucci MDBoard Certified Plastic SurgeonPlastic Surgery NorthwestSpokane, WA

Daniel Barrett, MD · Answer

Dear suprwmn72,
it is hard to tell for sure without an examination. If you are considering surgery, I would suggest you 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

Connie Hiers, MD, FACS · Answer

You did not post photos, but your gall bladder surgery large scar has cut across blood vessels that would normally keep all your tissue alive with a full tummy tuck. Since they have been cut, you could wind up with a large area of dead tissue and require multiple procedures and much worse scarring to repair. There might not be any or much blood flow to your lower abdominal skin. It is usually not worth the risk. Liposuction usually still can be done unless you have too many abdominal scars.  You need to do what is safe.

Camille Cash, MD · Answer

There are certain cases when previous surgeries will cause a person to not be a candidate for a tummy tuck.  The location and length of scars from previous incisions can place the patient at high risk for healing issues which could lead to infection and necrosis.  These are decided on a case by case basis.  I encourage you to visit with a board certified plastic surgeon near you to discuss your goals for surgery as well as your medical history.

Mats Hagstrom, MD (license on probation) · Answer

Having an open gallbladder incision creates potential blood flow issues when doing a full tummy tuck. This risk is drastically reduced by limiting the procedure to a mini tummy tuck.
In many ways having had the previous mini tummy tuck actually reduces your risk for having a surgical complication if you convert to a full tummy tuck.
I think you’ll find different surgeons have different opinions about this and there are a variety of risk factors that need to be taken into consideration.
For example doing the procedure on someone with a history of cigarette smoking would most likely lead to a very high risk of massive wound healing complications. The same is also true for someone who is obese or in poor health. A slim healthy person on the other hand could probably have a full tummy tuck with acceptable wound healing complications. Liposuction should not be affected by previous surgery and perhaps the doctor you met with simply doesn’t like or isn’t particularly good at Liposuction.
I highly recommend having multiple in person consultations to not only find different opinions but also to help find the most skilled and experienced provider.
While all plastic surgeons recognize the increased risk of having parallel scars it is not an absolute contraindication.
Different doctors will have different opinions and all risk factors need to be taken into consideration before giving an appropriate recommendation.
I suggest you continue your search and schedule more consultations.
During each consultation ask each provider to show their entire collection of before and after pictures. Pay close attention to who gets the most natural looking belly buttons. That in conjunction with a very low set scar that follows anatomic contours naturally are the hallmarks of quality work.
Being shown a handful of preselected pictures which most likely represent the best results of a providers career is insufficient to get a clear understanding of what average results look like in the hands of each provider.
Being accepted as being a candidate for the procedure is important but it’s also very important to choose a provider who can deliver quality results.
Best,
Mats Hagstrom MD

Am I the only one in world with past surgery scars and unable to have anything done?

Answers (7)

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