Pleating After Tummy Tuck- Options? (photo)

It looks like you are very early post op and it is too early to get worried.  When a shorter incision is desired or insisted upon, then the upper layer needs to be pleated to bring the skin together.  In general minor pleating flattens as the incision heals.  Hopefully they discussed with you beforehand the risk of shorter incision versus pleating.  Also, you do not post a pre-op pic, so we cannot see how much skin was actually removed.  The goal, of course, is a flap incision with no dog ear.   I hope this is helpful.

 

Good Luck.

to correct tummy tuck scars and pleating it is necessary to extend your abdominoplasty scar outwards. although most patients naturally want to limit the lenght of their tummy tuck scars, actually a minutely lenghtened scar will not be as noticable as a pleated short scar.

Your scars look normal this shortly after surgery.  The pleating WILL go away after about 3 months.  When I perform tummy tucks sometimes I need to pull in the skin and this creates the look you show us in your pictures.  I have yet to need to revise my scars.  I explain to my patients that they will look pretty awful right after the surgery and that over 3 months it will smooth out.  It always does.  The end points, however, seem like they may need a small touch up but that's something very minor that could be done just in the clinic with some freezing, you don't need to worry about requiring a major procedure.

 

Sincerely,

Martin Jugenburg, MD

Scars from tummy tuck can look pretty worrisome early on.  You are less than 2 weeks postop when these photos were taken and I can certainly see the pleating and dog ears you are concerned about.  However, you are very early in the healing process.  At this stage, things are very swollen, and swelling can make those pleats look pronounced and the dog ears look humongous.  It is very probable that you will smooth out nicely over time as the healing progresses.  I do understand your concern about living abroad and not being able to easily get a scar revision later.  However, reoperating this early with this amount of swelling and inflammation of the tissues may be really difficult and I would not do it.  I do believe that the majority of this will resolve on its own with time. 

Thank you for the question and pictures.

No, revisionary surgery is not indicated at this time. It may not be required long-term either. You will be amazed how the “pleating"  slowly resolves with time. The “dog ear"  will also improve with time ( but is  more likely to require revision surgery and the scar otherwise).

Your doctor is giving you good advice. 

Best wishes.

You are not even 2 weeks yet so it is still too early to be able to predict the long term outcome of your scar. Typically, much of the pleating will settle down/improve with time though it can take up to a year. Still, there may be some obvious contour irregularities that will persist.

Given your constraints and time frame, I would at least consider having your dog ear addressed prior to you leaving. This appears like it probably won't resolve fully even long term.

Yes it is very early in your healing phase. And yes a revision this early may be not the correct plan. But based upon the posted photos in my internet opinion you will need revision. Sorry. If you are leaving in Jan. than I might revise you in early Dec. but very hard to over the net advise. The "pleating could resolve but the dog ears need attention. Again hard to advise over the net. Seek in person second opinions. 

Hello,

The pleating that you are seeing is the result of two factors:

1) The upper incision is longer than the bottom incision. This is almost always the case with tummy tucks. 

2)  The upper incision was advanced toward the midline with reference to the bottom incision.  This was done in order to prevent dog-ears and to minimize the length of the incision.

Do not worry.  These will go away.  It may take about a month for the majority of them to be gone but they will go away.

All the best,

Dr Repta

I agree with everyone else, it is very early.  We often have to do some "gathering" to fit the longer upper incision with the shorter, lower incision especially when we are trying to keep the scar nice and low which most women prefer.  It looks worse now but much better later! Hang in there and give it time, you will look great!

The pleating will get much better in the next several weeks.. I would still wait at least several months, to allow the swelling to improve to see if a dog ear revision is needed.