Do I need a TT revision? (Photo)

Question

Hello, I got a ETT in 2019 but gained 30 lbs bc of covid, now i am at 135 which is 17lbs from my post op weight. I am unhappy with how my stomach looks, the loose skin, and the huge scar from my ETT. However, in the first ETT i faced huge blood lost and had to be transferred to the ER for a few weeks right after surgery so the idea of a revision tt is scary. Please let me know if i need a revision, or mini tt, or lipo and skin tightening. It does not look too bad when i stand up but sitting down

Zoran Potparic, MD · Answer

It is very difficult to give you good advise without in person consultation. Laxity of your skin would be the major factor to decide about procedures needed; TT/scar revision, aggressive liposuction, very likely combination of all three would be my consideration. Lowering of the scar without belly button repositioning would be revision TT recommendation. In person consultation is recommended. Good luck.

Daniel Barrett, MD · Answer

Dear Compassionate586304,
I understand your concern. However, without a proper assessment, it would be difficult to determine what went wrong. It is best that you visit your plastic surgeon for further assessment or ask for a second opinion. Only after a thorough examination, you can get proper recommendations and advice.
Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Camille Cash, MD · Answer

It does not appear you need a revision to your tummy tuck.  You could possibly consider a scar revision or liposuction, but based on the complications you experienced you may want to focus on diet and exercise to help you lose the weight that you gained over the past couple of years.

Douglas Taranow, DO, FACOS · Answer

You appear to require some liposuction due to your recent weight gain.  The TT scar is a bit wide and possibly thick.  A physical exam would determine if you require any further skin excision or revision of a portion of the scar (sometimes it is better to revise just a small portion of the scar to see how you heal vs the expense of a complete scar revision).  
Skin tightening rarely works well enough to justify the cost .
Best wishes.
Dr. Taranow

Darryl J. Blinski, MD · Answer

Based only on the posted photos I recommend complete scar revision of the extended TT scar. The fee $5,000 +/-. Best to in person or virtual consult.

Mats Hagstrom, MD (license on probation) · Answer

When contemplating doing a scar revision the surgeon and to some degree the patient as well should ask themselves why will the new scar heal better than the old scar.

If you can’t answer that question with a convincing answer then you probably shouldn’t have a scar revision.

Pulling more skin on your abdomen will create the need for repositioning your belly button and you’ll end up with an additional vertical scar.

Everyone tell me tuck procedure or not Will have skin laxity when the hips are flexed in the sitting position. If you had tight skin of your lower abdomen in the sitting position then you wouldn’t be able to stand up straight.

The result looks like a well done tummy tuck on somebody who heals poorly.  for hypertrophic scars there are a few things that may be worth trying. The first is an attempt at using silicone tape or silicone sheeting. You can buy these products on Amazon for about $20. Put in the search terms scar and silicone and look for ones that are about an inch wide and come in 6 foot rolls.

You can probably get away with cutting a 1 inch strip into half inch strips and leave it on for 3 to 5 days and then replace it. Do this for 3 to 4 months and each month take careful pictures to compare to see if the scar is improving.

For severely hypertrophic scars very conservative steroid injections can be tried but they put patients at risk for sitting out this car too much and making it wide.

While surgeons may have some opportunity to manage scars to some degree during the initial year of wound healing there isn’t much a plastic surgeon can do about how an individual patient heals other than to make a skin healing assessment by asking about previous injuries or previous scars during an in person consultation.

If it extended tummy tuck is needed then it’s better to have an extended tummy tuck. Unfortunately some people are genetically prone deformed highly visible scars.

I don’t personally see a good reason to redo your procedure because you’ll have to go through the whole healing process again and re-positioning your belly button I will leave one more scar.

Follow up with your provider and if you want a proper second opinion schedule an in person consultation with another local board-certified plastic surgeon.
Best,

Mats Hagstrom MD

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