Four years post op-still disappointed - is there anything I can do to treat these scars? (Photos)

The photos give some idea of the situation, although a complete assessment would require an in person consultation. The options below are listed from the most invasive to the least invasive.
Revision abdominoplastyThis can address the existing scars, remove or reposition excess tissue, and create a smoother abdominal contour.
Liposuction or liposculptureEspecially for the fullness above the horizontal scar, liposuction can refine the contour and achieve a more natural line.
Scar revisionThe scar around the belly button and the vertical incision may be treated with revision techniques or laser resurfacing to make them less noticeable.
Skin tightening treatments with laser, radiofrequency, or ultrasoundThese less invasive options may help with mild laxity and surface irregularities, but they do not provide the same level of improvement as surgery.
I have shared a detailed video where I explain the revision process step by step and show examples of different incision types and healing patterns from my patients. This may help you visualize what improvements are possible.
I hope this gives you a clearer idea of the available options. A consultation with a board certified plastic surgeon experienced in revision abdominoplasty would be the best next step.
— Güray Yesiladali, MD

You might consider getting a second opinion about your concerns. The umbilical scar may be relatively difficult to hide at this point. The lower abdominal area might be able to be improved with liposuction and perhaps other manipulation. Another plastic surgeon may have some ideas after a good physical exam.

Thanks for your question! I'm not sure that scar revision is the answer. You may need more skin excised or some liposuction to smooth out the contours. If you have any loose skin, maybe a bit more can be removed to try to lessen the vertical incision. I would suggest an in person consultation. Good luck!

Thank you for your question! Since noticeable time has elapsed, and your surgeon appears unwilling to work with you, a second opinion may be necessary. The TT scar can certainly be revised and the skin flap can be elevated a little bit and tightened to make it look less retracted after revision. The vertical scar can be made a little shorter only and was likely made due to your slender frame at the time of surgery to prevent wound healing issues. Hoping you find satisfactory answers!

It has been 4 years since your tummy tuck. For your concerns, we would recommend revision scar surgery, liposuction to improve the bulging at the upper scar fold area, and umbilicoplasty to enhance the appearance of the belly button.

I'm sorry you are unhappy with your results. Though your scars appear to have healed well, the contour could be improved. A revision would be needed to remove excess fat and to revise the appearance of the belly button. See a board certified plastic surgeon near you for a consultation.

To make a quality assessment regarding the outcome of any plastic surgery procedure we need to see quality before and after pictures.
If you don’t have a complete set of proper before, and after pictures, then ask your surgeon to forward the pictures they took.
Your abdomen is bulging a bit.
There are a few reasons this can happen.
One of the variables is excess visceral fat.
Another one is muscle separation from previous pregnancies.
It would be helpful to know if muscle tightening was part of your procedure.
It’s not uncommon for people to have an abrupt transition with thicker subcutaneous fat above the scar line.
Normally the thickness of fat on the lower abdomen transitions from being very thin in the groin area to its thickest around the mid abdomen.
When this transitional area is removed during a tummy tuck, the transition of fat from thin tooth thick becomes very abrupt.
This abrupt change Just above this car can be improved with Liposuction.
To get a quality assessment, I suggest scheduling in person second opinion consultations.
For second opinion, consultations come prepared bringing with you a complete set of before and after pictures and a copy of your operative report.
These are part of your medical record that you can request from your provider.
Your scar has healed really well.
I don’t think you could hope for a less visible scar.
Best,
Mats Hagstrom MD