Tummy Tuck and Vertical Scar
I wish I had your tummy! Congrats on a great figure after 2 children! Based on your pictures, I would likely tell you not to waste your money, and just enjoy being with your kids. If you really pushed me, I could be talked into revising your vertical scar and tightening your 6-pack muscles through this same incision. Some lipo of your lower abdomen and flanks would be done at the same time. Of course, you would really have to push for surgery to get me to do this. Congrats again.
Asif Pirani, MD, FRCS(C)
No tummy tuck scar revision possible but there are risks
You look excellent! You do not need a tummy tuck and another scar!
Vertical scar revision is possible but there is always a chance that the new scar will not heal well even if done by a plastic surgeon.
A complex but very nice scar correction of a vertical c-section scar is pictured here. This scar was depressed or contracted which is a very common result when a scar like yours is just cut out and sutured closed.
In this patient I removed the scar and then used SlimLipo laser assisted liposuction to flatten the fatty areas around the depression so that the area would heal smoothly without contraction and a depression-the result was excellent.
This is a lot of trouble for you to go through, but if you really want to improve the scar, that is the technique I would use.
I do not think you have enough excess skin to have a tummy tuck to adequately remove the scar.
Liposuction and scar revision
By your picture it appears that you have good skin tone with a darker skin color. Although it's difficult to truly appreciate the scar it does appear widened and hyperpigmented. In addition you do have some extra fat of the abdomen and lower abdominal protrusion "the pooch."
I think you would get a fantastic result with liposuction of the abdomen and flanks. Then using the vertical scar remove any extra skin and tighten the abdominal muscles below the belly button. The scar would be better as it would be closed in many more layers, thus less tension.
A horizontal incision would only add scarring. And since the entire vertical scar would not be able to be removed there's no sense in adding additional scarring.
Standard Abdominoplasty or Scar Revision
You look fantastic after two vertical C-sections. Your skin tone is of a darker color and more easily prone to hyperpigmentation, which makes the vertical C-section scar more visible. The lower part of your abdomen shows separation of the rectus muscles, which makes your lower abdomen "pooch". The only way to completely remove the vertical C-section scar is with a full abdominoplasty, which really just trades one scar for another. Also, it appears you may not have enough skin laxity to have a full tummy tuck without leaving a very long horizontal scar. Your have some extra fatty tissue on the abdomen and hip area which would benefit from liposuction.
My recommendation is a scar revision of the vertical C-section scar, to minimize scarring. At the time of the scar revision I would repair the rectus diastasis below your umbilicus. By pulling these muscle more closely together, the tension on the vertical scar revision is minimized and should give you an excellent result. I would also liposuction your hips, waistline, and upper abdomen at the time of the vertical scar revision and rectus muscle repair.
Your abdomen looks good for 2 children. You are staying in good shape but despite your best efforts, a bit of liposuction could help the slight bulging. If you are prepared for a larger procedure, then a modified tummy tuck could be planned to minimize the length of the scar to your desires.
Tummy tuck or scar revision
I always am amazed how many people pose their view on here without taking into acount the patients view. You do look good after having children but obviously something bothers you about your appearance or you would not have asked the question. I typically see this question in those that want to still wear a two piece without all the questions or looks that come from the scar. I see several women with the same type of scar and concerns. Prior to answering you should really be examined because what to do depends on the degree of laxity. If a person can change a scar they can't hide in a bathing suit for one they can then yes this would be a great thing in most women's eyes. So have a consultation with a very experienced plastic surgeon. During the consultation they will see just how much laxity is present. If there is enough laxity to remove the entire vertical scar while still keeping a tummy tuck scar low then the answer is simple....the tummy tuck results will far out way the results of simple scar revision to the vertical scar itself. I perform hundreds of tummy tucks per year and yours should be a very simple decision after a proper examine. But if there is not enough laxity then either simple scar revision or leave well enough alone.
Tummy tuck scar/ C section
If you have a vertical scar from a C section (as depicted in the photo) a tummy tuck can remove the scar provided you have enough skin laxity. The skin from your belly button to your pubic area will be removed during a tummy tuck, which should treat your abdomen quite well.
Tummy tuck vs scar revision- a common question
Routinely patients ask if a scar revision will have an effect of a tummy tuck. As expected, the answer is NO. A scar revision will only address the immediate area of the scar. A tummy tuck will not only re-orient a vertical scar into a horizontal one, tighten the abdominal muscles, remove excess skin but also remove excess fat. Which procedure to have always depends on what the patient's expectations are and which surgical procedure can meet them. Most importantely, the discussion about the patient's expectations must take place BEFORE the surgery takes place!
Abdominoplasty scar better than vertical ?
To my experience, a vertical scar in the lower abdomen is very troublesome.
If you decide to go for the scar-trading concept, i.e. "change" the vertical scar for a horizontal abdominoplasty scar, I think that you will likely be happier with that.
The abdominoplasty scar is much easier to hid on the beach.
A scar revision could make the scar look a bit neater. It seems that you current lower abodminal scar is a bit distended.
Congratulations on your children, and your good work in the gym. You look great!
Now for the scar issue. I see this quite a bit, and your scar is actually not that bad. That said, the quality of a scar depends on how it is made, and how it is oriented regarding natural skin wrinkles. Unfortunately, the vertical scar is perpendicular to the natural wrinkles, and will tend to form a less attractive scar than a tummy tuck scar.
At two years out, you scar is mostly what it will ever be. A scar revision may give you some improvement, and that may be good enough for you. A tummy tuck will remove all the tissue basically between the pubis and the navel. The scar will likely be from hip to hip, in order to get rid of the midline scar.
Fortunately, there will be many other aesthetic benefits, and the scar will tend to be better than the midline.
So, you need to decide how to go. You may also choose to do nothing. But to make an omlette...