Will Tummy Tuck Incision on Stretch Marks Cause Problems?

Question

If during a Tummy Tuck the incision made is through wide stretch marks, will the thin skin cause any healing problems?

J. Timothy Katzen, MD, FACS · Answer

Thank you for your question regarding whether a tummy tuck incision made through stretch marks could cause healing problems. Stretch marks occur when the skin is stretched beyond its capacity, resulting in thinned skin that can sometimes be more fragile.

In general, making an incision through stretch marks does not typically cause significant healing issues. However, because the skin in these areas is weaker and may have less elasticity, it could take slightly longer to heal compared to healthy, more resilient skin. Fortunately, during a tummy tuck, most plastic surgeons will remove a large portion of the skin containing stretch marks, so you may notice that many of them are significantly reduced or eliminated after surgery.

Healing complications, such as poor scar formation or delayed healing, are rare but can happen, especially if the skin is particularly thin or damaged. However, most board-certified plastic surgeons are experienced in working with this type of skin and will take steps to ensure proper wound care and healing.

To minimize the risk of healing issues, it’s essential to follow your surgeon's post-operative care instructions carefully. This includes keeping the incision clean, avoiding tension on the area, and wearing any compression garments as directed.

If you have any specific concerns, I recommend consulting with a board-certified plastic surgeon who can assess the condition of your skin and ensure you have a smooth recovery.

Sincerely,
Dr. Katzen

Louis P. Bucky, MD · Answer

If an incision is made through wide stretch marks, healing will not necessarily be affected. Healing is most directly related to surgical technique and the patient's predisposition to healing and following post-surgical directions.

Christopher L. Hess, MD · Answer

Your question is actually interesting and not without merit.  Stretch marks are actually caused by rapid stretching of the skin such that occurs with pregnancy or weight gain.  Genetics plays a large role.  Some patients have skin that is less elastic and thus more susceptible to stretch marks.  The appearance of these marks is due to splitting of the dermis (the deeper layer of skin) with an intact epidermis (the superficial layer).
Since the dermis is the main structural layer of the skin your question does pose an interesting theory.  It would stand to reason that the tummy tuck incision would not heal as well.  Fortunately, reality does not follow this theory as having done many tummy tucks on women with bad stretch marks I have not found there to be a problem with healing.

Peter A. Aldea, MD · Answer

Dear Debnfl,
Do not worry. We do it ALL the time.
Stretch marks are cracks through the dermis caused by sudden stretching which heal with scar tissue. For this reason they cannot be removed DESPITE the billions of dollars spent on ads telling you that.
An abdominoplasty will remove much of the stretch marks damaged skin below the belly button. Since the wound is held together with several layers of stitches UNDER the skin and the stretch marks, there should be no tension on them and they usually heal without a problem.
I would not postpone having an abdominoplasty based on this consideration.
Hope this was helpful.

Robin T.W. Yuan, MD · Answer

Stretch marks are caused by changes in the dermal thickness of the skin. If the marks are extremely thin, this may make suturing to the opposing skin a bit difficult and the skin can swelll differentially causing temporary surface contour irregularities. There can also be potential "step-off" of soft tissue thickness that this thinning contribute to. These are all trade-offs to the positives of an improved contour.

Nirav Savalia, MD · Answer

Hi,
Placing the scar directly across stretch marks is not uncommon in tummy tucks, since it is usually not possible to remove ALL of the stretch marks. You are right to question healing, since it is more difficult to sew together skin that has stretch marks on it, however it should not impact healing of the scar itself.

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