Is a full tummy tuck needed, or would a scar revision combined with a skin tightening / lipo procedure be sufficient? (Photos)

Question

I am a Uk size 8 and I have been left with a tethered c section scar that has created a shelf. I also have some stubborn fat in the stomach area that I struggle to lose. I am just wondering if a full tummy tuck is what I need, or if a scar revision combined with a skin tightening / lipo procedure would be sufficient?

Mert Demirel, MD · Answer

A tethered C-section scar can create a shelf because the scar is stuck down to deeper tissue while the skin and fat above it hang over. If the problem is very localized, scar release or scar revision with limited liposuction can sometimes improve it.
However, if there is loose skin across the lower abdomen, abdominal wall laxity, or a wider lower belly fullness, a full tummy tuck may give a more complete and predictable correction. A tummy tuck can remove the old scar area, release the tethering, remove extra lower abdominal skin, and tighten the abdominal wall if needed.
Skin-tightening procedures have limited power for this type of problem. They may improve mild laxity, but they usually cannot remove a true skin fold or fully correct a tethered scar shelf. Liposuction alone can also make the looseness look worse if the skin does not retract well.
From the photo, you may be between options: a focused scar revision may help the tethering, but a full tummy tuck would likely give the most complete abdominal contour improvement if you want a flatter and smoother result.
The best choice depends on your goal. If you only want the C-section shelf improved, ask about scar release/revision with conservative liposuction. If you want the whole lower abdomen flatter and tighter, a full tummy tuck is more likely to be the right procedure.

Robert M. Lowen, MD · Answer

Dear St,
   You have sufficient loose skin, fat and abdominal wall relaxation that would make a full tummy tuck the most rewarding for you.  You already have a lower abdominal scar from the C-section and a lot of stretched, excess skin in the lower abdomen.  With a tummy tuck and 360 lipo, the old C-section scar would be removed, the excess fat removed, the muscles tightened for a flatter, pre-pregnancy shape, and all the excess skin removed.  While lipo and scar revision with some skin excess removal can be done, it will  leave you with loose skin above the umbilicus which is not attractive, and a pulled down belly button, and no correction of the muscle separation.

Semih Yildiz, MD, FEBOPRAS · Answer

From the photo, there appears to be a localized lower-abdominal shelf related to scar tethering and some lower abdominal fullness, but the right procedure depends on an exam. I would look at skin elasticity, scar mobility, fat thickness, and whether there is any muscle separation. A full tummy tuck is usually considered when there is meaningful loose skin, an overhang, or diastasis that needs correction; body size alone does not decide it.
If the main problem is a fixed C-section scar with only mild laxity, scar release or revision, sometimes combined with conservative liposuction or skin tightening, may be enough. If the skin has limited recoil or the shelf is partly excess skin, smaller procedures can improve the area but may leave some looseness. An in-person plastic surgery consultation with a pinch test is the best way to choose between these options.

Nicholas Lahar, MD · Answer

Hi ST1982, your case is a great example of someone who falls in between our main treatments of liposuction versus tummy tuck. I believe you can get a very nice result with either one but For an abdomen with some skin laxity like you have, you may experience collapse of the skin in the upper abdomen if you have liposuction only. The skin tightening *should* help with that but it is unfortunately also a little unpredictable. On the plus side, you would be saving yourself from the skin and elevation and the larger surgery by just doing liposuction, skin tightening, and "mini" tummy tuck. On the other hand, a full tummy tuck combined with liposuction is the surest way to get rid of skin laxity. In proper hands, it should leave you with the flattest possible abdomen as well as tighten and tone the abdominal muscles. 
Long story short, you can "reasonably" have both options but the tummy tuck should be more tight. Just make sure your potential surgeon has a good track record of similar body types

Daniel Barrett, MD · Answer

Dear ST1982,

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

Gregory Lakin, MD · Answer

Thank you for your question. You look like the main problem is a tethered C-section scar with a shelf, and your skin elsewhere is still fairly tight, so a liposuction with scar revision and release of the tethering may be enough. A tummy tuck is the procedure that removes extra skin and can also remove the old C-section scar, so it might be indicated if you have extra loose skin, skin laxity above and below the belly button, or muscle separation (diastasis). Having an in-person examination with a board-certified surgeon is the only way to tell which category you fall into and which is the best option for you.

Leila Kasrai, MD, FRCSC · Answer

It looks like you may have loose skin above your belly button. For this reason, a full tummy tuck would be more suitable.

Paul M. Parker, MD, FACS · Answer

You appear to be a great candidate for a full tummy tuck based on the pictures you submitted. In my opinion, this would give you a far better result than scar revision. My best advice it so obtain a face to face consultation with a board certified plastic surgeon who performs a lot of tummy tucks near you. They can examine you as well as discuss these and other options in detail once they have done so.

Ira H. Rex III, MD · Answer

The choice of surgery all depends on your expectations.  Whether you need or want muscle tightening, tight skin above your bellybutton, willingness to have a small vertical scar above the pubic area, and other considerations.  A board certified plastic surgeon who specializes in abdominoplasty and contouring could help you decide better regarding the benefits and trade-offs of each surgery you mentioned.  Good luck.  It seems you are a good candidate for either of these surgeries, depending on your expectations.

Kadir Berat Oyur, MD · Answer

Thank you for your question. Based on your photos and description, it appears there is a tethered C-section scar with localized fat and mild skin looseness.
You would be a suitable candidate for liposuction with J-Plasma to improve contour, reduce fat, and tighten the skin in this area.
I hope this helps.

Is a full tummy tuck needed, or would a scar revision combined with a skin tightening / lipo procedure be sufficient? (Photos)

Answers (15)

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