Rippling above belly button 14 months post muscle repair, umbilical hernia and tummy tuck. How can this be fixed? (Photos)

Question

14 months ago, I had muscle repair, umbilical hernia and tummy tuck. I’ve had 3 big baby with 3 csections. Being already athletic, with little fat and excess skin, I was pulled really tight. However, now I’m noticing rippling above my belly button. What could this be?

Robert M. Wald, Jr., MD · Answer

There is not a good solution to this problem. Rippling is inherent in your skin. Some non invasive machines may help but they will not eradicate them.

Guray Yesiladali, MD, FEBOPRAS · Answer

The photos help to illustrate your concern, although a full evaluation would require an in-person consultation. Based on your description and timing, a few possibilities may explain the rippling you see above the belly button:
Skin pulled very tight during the tummy tuck.When there is little fat and skin to begin with, the surface can sometimes show fine ripples after being stretched.
Adhesion of tissues under the skin.The healing process can cause the skin to stick unevenly to the underlying layer, creating visible contour irregularities.
Thin fat layer over the repaired muscle.In athletic patients, the lack of a cushioning fat layer can make repaired muscle edges or sutures more visible through the skin.
Possibility of recurrent hernia or muscle separation.This is less common, but should always be examined in person to rule out a structural issue.
In many cases, this type of rippling is more of an aesthetic concern than a medical one. Treatments like laser or radiofrequency skin tightening or small-volume fat grafting can help soften the appearance. If there is any suspicion of a structural problem, a surgical revision may be considered.
I hope this explanation helps clarify the possible reasons. A consultation with a board-certified plastic surgeon will give you the best plan going forward.
&mdash; Güray Yesiladali, MD

Steve Laverson, MD, FACS · Answer

Loose skin can be positional (there is more when you are flexed) or related to diminished skin elasticity, fascial tightening without proportional skin advancement, or even related to drain position, post-surgical garments, relationship of skin to fat, scar formation, low belly button inset, or some combination of these causes.  Every situation must be individually evaluated to formulate solutions.

Kamol Pansritum, MD · Answer

This kind of rippling above the belly button is actually quite common after a tight muscle repair and tummy tuck, especially in athletic patients with thin tissue.
It’s usually not a hernia or muscle issue, but rather a superficial contour irregularity caused by thinning of the fat layer and some scar tethering of the skin.
The good news is that it’s typically treated without surgery. Options like radiofrequency or laser therapy, subcision, or lymphatic drainage massage can help smooth the area by improving collagen and releasing the scar tissue.

Rippling above belly button 14 months post muscle repair, umbilical hernia and tummy tuck. How can this be fixed? (Photos)

Answers (4)

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