Concerns After Tummy Tuck, Hernia Repair, and Pelvic Adhesions Removal

Question

I had a Tummy Tuck (5 weeks ago) performed by a plastic surgeon. At the same time, I had an umbilicus hernia repaired by a general surgeon, and pelvic adhesions removed by my OB/GYN.I am extremely unhappy with the way my belly button looks. It seems to me that my plastic surgeon cut too big of a hole for my "new" belly button. I have a sort of crest shaped cut out which is about 1 1/4 inches wide by 1 1/2 inches long with the belly button crease  partly inside the crest and partly above the crest. I have scoured through tummy tuck pictures on the internet and have not seem anything like this.The plastic surgeon said this outcome is due to the other two doctors having to do work on me (which is hard to believe because they performed their part laparoscopically) and she tells me that my belly button is not going to look this way, but is going to look better down the line because it takes six months to heal. Can you tell me if this sounds normal to you?The doctor did say that if I am unhappy with the results six months later that she would fix my belly button in the office by cutting out some of the flesh within the crest like seam line and pull it all together. I used to sew and I can't picture how she will be able to do this without leaving pleats emanating from the belly button to the surrounding stomach skin.In addition, I have small pleats in my tummy tuck incision line and have "dog ears" at the ends. The doctor said she would fix the dog ears in 6 months, but are the small pleats normal? Also, I seem to have a bit of a tummy still. Is this swelling that will go away? I am so upset and would appreciate any advice you can give me regarding addressing my belly button concerns and possible repair with the doctor.

Matthew Schulman, MD · Answer

It is true that it takes several months for scars to heal, so it is difficult to have an idea of the final result for a while.  But, in my experience, if something does not look good early on, it is unlikely that the healing process will make it look better as times goes on. This being said, I think it is still reasonable to wait at least 6 months before doing any revision because of the scar tissue.
Small "dog ears" often shrink over 6 months, and larger ones often need to be revised in the office - so what you describe is not unusual. 
Regarding the belly button - a large belly button can be made smaller. There will be some "pleats" but if done correctly, the "pleats" can be placed in an area of the belly button that looks natural. Remember, your belly button is just a scar and it has naturally has "pleats."
Given the extent of your surgery, it is not uncommon to need some revisional procedure. If you are comfortable with your surgeon and her ability, then you should allow her to revise it at around 6 months as planned. If you are not comfortable with her, then you can always seek out another board certified plastic surgeon in you area for a second opinion.

Robert Frank, MD · Answer

I can address your pleating problem...Its not uncommon to have to pull from the sides toward the middle during an abdominoplasty which can result (temporarily) in some small pleats. These will fade and disappear over the first 2-3 months post op.
Also, so you know, there are many journal articles and whole sessions at national meetings devoted to belly button design. I don't think any of us have it perfect 100% of the time. I would wait and understand that a small office procedure to fix it may be necessary down the road.

Kenneth R. Francis, MD, FACS · Answer

Your surgery was a very short time ago.  You need to allow at least 6 months for scar contracture and skin tightening before critically evaluating your results.  Things will certainly change, hopefully for the better.  Good luck!

George J. Beraka, MD (retired) · Answer

Hi.  Of course your appearance will change over the next several months, and you should not consider a revision for 6 months, but from your description, things will not improve enough on their own.
The pleats may fade, and the dog ears can be removed.  I don't know why you still have some bulging.  It could be residual fat, or your rectus muscles may need further tightening.  The belly button can probably be made smaller and more attractive with a purse string suture.

Theodore Katz, MD, FACS (retired) · Answer

Most patients are by nature impatient to see the final results of their procedures and expect that they should be appraent almost immediately. You should continue to see improvement as time goes on and any residual problems can be addressed. "Dog ears" or standing cones are common and improve quite a bit with time and if necessary any residual can usually be treated under local anesthesia in the office.
Oftentimes this is true about the belly button as well. Skin is elalstic, as opposed to fixed dress material and the "sewing" may be similar but the ability of the skin to stretch enables the surgeon to take advanatge of this property of skin and address the "pleating" that you have. The hard part for you is the waiting and it is easy for the surgeon to say be patient, but concentrate now on complying with your post operative routine.

Concerns After Tummy Tuck, Hernia Repair, and Pelvic Adhesions Removal

Answers (5)