Can this be fixed? Incisions and asymmetry? (Photos)

Question

I had a 360 tummy tuck with a butt lift and auto augmentation. Also knows as a gluteal flap and parasacral propeller flap. I am very disappointed with the outcome I have received. Is it possible to do fix the incision to be outside of my butt crack? I am wanting a much cleaner incision similar to the one posted below. Is it possible to do a full reversal? I am so unhappy. Thank you for your response.

J. Timothy Katzen, MD, FACS · Answer

Hello, Funny 40762.  Thank you for your question regarding whether your buttock lift can be fixed and, specifically, can the butt lift incision and asymmetry be corrected.  Thank you for your pictures and your history.  First, let's analyze your pictures.  You had a 360 circumferential lower body lift with auto tissue augmentation.  This is also called a propeller flap.  This is a commonly used technique to augment the buttock.  Other ways to augment the buttock include FDA-approved buttock implants and fat transfer (Brazilian Buttock lift (BBL)).  Another name for the 360 circumferential lower body lift is a 360 tummy tuck.  However, 360 tummy tuck is inaccurate because your hips and buttocks are elevated, and the hips and buttocks are not part of the tummy.  You must clarify and discuss exactly what you do not like with your plastic surgeon.  The pictures that you posted show excellent results.  As far as mobilizing the buttock lift incision outside the butt crack, this maneuver will be very difficult.  Since the incision is now part of the butt crack, it is difficult to disconnect the scar and incision line from the butt crack.  In terms of a "full reversal" of your buttock lift, a "full reversal" is impossible because the tissue (skin and fat) was thrown away during your 360 tummy tuck or lower body lift.  You need to clarify exactly what you want and what a "full reversal" means with your plastic surgeon.  Either way, let your body heal from the 360 tummy tuck surgery for at least 6 to 8 months.  It will take a while for the swelling to dissipate and the fat cells to heal.  Other possible revisions could include liposuction of the area or even a complete scar revision.  Depending on what area still bothers you, revision could include the tummy, hips, and backside.  The take-home message is that you need to clarify exactly what you do not like with your plastic surgeon and what is the ideal you are seeking.  Good luck.  I hope I've answered your question regarding whether your 360 tummy tuck with butt lift and auto augmentation can be fixed and whether the incisions and asymmetry can be corrected.
If you have any more questions regarding the lower body lift, 360 circumferential lower body lift, belt lipectomy, belt abdominoplasty, or belt dermolipectomy, please get in touch with an experienced plastic surgeon. Since the body lift is a big procedure, please seek an experienced, board-certified plastic surgeon with significant experience performing the lower body lift. Do your research.  Ensure they have performed at least 100 circumferential lower body lift surgeries and have the before and after pictures to prove it.  Carefully examine their before and after pictures and check their reviews on RealSelf.   If you cannot find an experienced lower body lift surgeon in your neighborhood, consider traveling out of state. Sincerely, Dr. Katzen, MD, MBA (President of the American Society of Bariatric Plastic Surgeons, certified by the American Board of Plastic Surgery, Fellow of the International Society of Aesthetic Plastic Surgery, American College of Surgery, and International College of Surgery, and member of the American Society of Plastic Surgery, American Academy of Cosmetic Surgery RealSelf Hall of Fame, and RealSelf Doctor Advisory Board for Medical Review and Consumer Panel.)

Miguel Mota, MD · Answer

I understand your concerns about the incision placement and asymmetry. This is not that big a a problem because these can be revised and placement can be improved. 
The good thing is that your overall result is good, and scar revision should work. I would recommend waiting at least 6 months before revision though.
Best of luck,
Dr. Miguel Mota

Gary M. Horndeski, MD · Answer

The asymmetry can be improved upon but if the incision is going into the buttocks crease then it cannot be moved from it.  The asymmetry can be corrected with a scar revision and some liposuction.

Best Wishes,

Gary Horndeski, M.D.

Zoran Potparic, MD · Answer

Asymmetry of the scars and deficiencies in volume can be corrected to a certain degree. Unfortunately a full reversal is impossible because a buried flap is deepitalized ( has no skin surface). Incision within buttock crack may be improved with well planed scar revision but not completely taken out. For all of this you will need an experienced board certified plastic surgeon with good reconstructive background. Good luck.

Rajaie Hazboun, MD, MBA · Answer

Thank you for posting your question here, may answer will be based on the limited information and pictures provided, for a more bespoke and detailed plan please consult with your plastic surgeon.
I am sorry that you are unhappy with your results, but rest assured most issues can be improved. from your pictures it looks like you had your surgery relatively recently . I would not rush into trying to get a revision just yet. I would encourage you to wait until things settle down, you will still have some swelling and might not have enough laxity to undergo a revision without having excessive tension on the new incisions.
I would encourage you to discuss your concerns with your surgeon, I am sure they will strive to improve your result.I hope this helps, best of luck!

Mats Hagstrom, MD (license on probation) · Answer

As a general statement, it may be possible to raise an incision after this kind of surgery, but it’s probably not realistic to think you can raise the incision line.
How many before and after pictures of the previous patients who had similar body characteristics who had the same procedure did your surgeon show you before you had the procedure?
I suggest you wait a year and a half before making your final assessment.
Scars take a long time before they fade out.
To get a proper second opinion consultation I suggest always doing so by bringing your complete set of before and after pictures.
If you don’t have before, and after pictures, then ask your surgeon to forward the pictures they took.
I also recommend your Eli exclusively on in person. Second opinion consultations, even if they cost money.
 Best,
Mats Hagstrom MD

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