Scar Under Belly Button After Tummy Tuck

Question

Recently, I had a Tummy Tuck with inguinal hernia repair about 8 weeks ago. My plastic surgeon stated I could have a mini Tummy Tuck. Turns out I had severe Diastasis Recti, so my tummy tuck became standard? I was surprised to see the 2 inch scar below my belly button after surgery, and was told that the skin had changed color from being too tight, so this scar was necessary. I am not pleased with the look of either this scar or my belly button and I also still see abdominal profile as bulging as before. What happened?

J. Timothy Katzen, MD, FACS · Answer

Thank you for reaching out with your question about the presence of a scar underneath your belly button following a tummy tuck (abdominoplasty). Understanding the specifics of your surgery is important in addressing your concerns.
Based on your description, it seems your procedure involved more than just a mini tummy tuck, which typically focuses only on removing excess skin and fat. The fact that you had muscle correction and alterations, as well as surgery involving your umbilicus, indicates a more extensive procedure.
The incision around your belly button might have been necessary for the repositioning of the belly button. This often happens in cases where the abdominal skin is tightened significantly, potentially causing the belly button to shift downward. To correct this and reorient the belly button to its anatomical position, an incision is usually required.
As for the cause or treatment of the discolored skin, this is a specific detail that only your plastic surgeon can clarify, as they have complete knowledge of what occurred during your surgery.
If you have questions or concerns about your surgery, especially about the scar formation and its reasons, the best course of action is to discuss them directly with your plastic surgeon. They can provide the most accurate explanations and guidance based on your individual surgery and healing process.
In case you are dissatisfied with the results, exploring the option of a revision surgery with your surgeon is advisable. A revision might involve a larger incision, further muscle plication (tightening), correction of the belly button positioning, and additional removal of excess skin and fat.
I hope this information offers some clarity regarding the scar underneath your belly button after your tummy tuck. Don't hesitate to consult your plastic surgeon for more personalized and detailed insights.
Good luck, and I hope you achieve the results you are seeking.
Sincerely,
Dr. Katzen

Raffy Karamanoukian, MD, FACS · Answer

Abdominoplasty scars can be quite complex, ranging from the simple hypertrophic scar to a multiplane inflamed keloid. Pigmentation, discoloration, chronic inflammation, scar visibility can all occur in the short term. We begin each treatment with combination therapy using Yellow broadband BBL, Vbeam, fractional erbium, intralesional IIT, and scar modulation. Start with a combination of Plato's Scar Serum massaged twice daily after one week of epithelialization followed by Luminase/Exfolase. Scar consultation and revision may be recommended.

Best,
Dr. Karamanoukian
Realself100 Surgeon

Best, 
Dr. Karamanoukian
Realself100 Surgeon

Otto Joseph Placik, MD · Answer

The circumstances you describe indicate that the surgeon was telling you the truth and that his/her intra-operative observations were not consistent with his/her pre-operative assessment requiring a change in plan. He/she converted from a mini to a full tummy tuck but one in which the low lying incision prevented complete excision of all the infra-abdominal skin. This left you with the vertical umbilical incision which likely hyperpigmented. Over time this should lighten in appearance (2 years).

Steven Wallach, MD · Answer

A small scar under the umbilicus if it is betweent he closure and the new umbilical closure may represent the old scar from the umbilicus.  Without photos or an exam it is hard to say.

Pat Pazmino, MD, FACS · Answer

Tummy tucks are very popular and effective way to contour the abdomen. A tummy tuck is designed by using a low abdominal scar along with a small scar at the bellybutton. It is unusual to have a scar underneath the bellybutton. Discuss with your plastic surgeon the placement of the scar. It may have been necessary to perform because of some characteristic of the hernia repair.

	If you are unhappy with the appearance of the scar, discuss with your search in the different modalities that may be used to make the scar less obvious.

	To learn more about tummy tucks, see photos, and help you decide which one is best for you, please visit us at the link below:

John P. Di Saia, MD · Answer

Hello,
Sometimes the extent of surgery needed to fix a problem is hard to figure in surgery or pre-operatively. This can be a matter of experience, but even with experience can come the nature of variable healing. It sounds like the plan for a mini tummy tuck was seen intra-operatively as insufficient. Post-operatively, your correction may not be holding up.
You may be looking at a revision for whatever reason.

Robert S. Houser, DO · Answer

For most surgeons, if it was clear that you were to have a mini tummy tuck going in to surgery, that's what would have been done. An extensive repair of a rectus diastasis generally requires a full abdominoplasty (with a scar around the belly button) or "floating" the belly button where it is detached, then re-sutured to the abdominal wall (this avoids the scar around your belly button). Certainly, there are other ways as well, but if a full abdominoplasty is to be performed and there is not enough skin to remove everything from the pubic area to the belly button, then the patient is made aware before surgery that there would be a vertical scar below the belly button where the belly button used to be. That can be a deal breaker for some women, and so other approaches are used (to repair as much of the diastasis as possible). If something looked compromised at the time of surgery, then I'm sure your surgeon did what he felt was best for you to avoid anything disastrous. He/She my be able to revise something in the future once things have healed. Good luck!

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