Tummy Tuck Using Same Incision for C-section?

                  It’s
not unusual for patients who are undergoing abdominoplasty to have given birth
by C-section.  The vast majority of
C section scars are oriented transversely and are located at the level of the
pubic hairline.  Rarely these
incisions are vertically oriented and in most cases are
entirely removed during abdominoplasty when they are located below the level of
the umbilicus.

                   When
C-section incisions are oriented transversely, the abdominoplasty incision is
made slightly below the C-section incision.  The C-section scar is totally removed and replaced by a
longer incision that’s located slightly lower than the original C-section scar.

                   It’s
important that the abdominoplasty incision not be made above the C-section
scar.  In some cases this can
result in loss of blood supply to the intervening tissue and can potentially
result in wound healing problems.

                   If
you’ve had a previous C-section and are concerned about abdominoplasty incision
placement it’s important to consult a board certified plastic surgeon.  This surgeon should be able to
formulate an appropriate treatment plan for your condition.

Hello Mommyto3,

Thank you for your question regarding the use of the same incision for a tummy tuck and C-section.

During a tummy tuck, an incision is made underneath the C-section scar. This incision is typically placed several millimeters or several centimeters below the C-section scar, depending on the position of the C-section scar and the amount of skin that needs to be removed. The entire C-section scar is revised during a tummy tuck, ensuring a more aesthetically pleasing result.

Regarding your specific questions, there is no state regulation limiting the amount of skin that can be removed during a tummy tuck. However, there are restrictions on the volume of liposuction that can be performed. You mentioned that you gained a significant amount of weight. It would be beneficial to know your current weight to provide a more tailored recommendation. If you are obese, it is crucial to lose weight before undergoing a tummy tuck. Ideally, your BMI should be less than 30 to achieve the best surgical outcome.

In summary, the tummy tuck incision can effectively revise your C-section scar, and there are no specific restrictions on the amount of skin that can be removed. It is in your best interest to lose as much weight as possible before surgery. Consult with a board-certified plastic surgeon experienced in treating patients with a history of weight fluctuations and C-sections.

Good luck. I hope I’ve answered your question regarding tummy tuck procedures and considerations.

Sincerely,

J. Timothy Katzen, MD, FASMBS, FICS

However the length of the tummy tuck scar will have to be longer than your E-section scar.  Your need to lose weight would depend on how much you have gained.  There is no limit on how much can be removed when is come to skin.  Each plastic surgeon decides the right amount at the time of the surgical markings.  There is a limit as to how much fat can be removed with liposuction.

When an abdominoplasty is performed in a patient who has a previous C-section scar the scar is usually excised and removed as part of the lower abdominal incision.  This keeps the scar in a good position for clothing and swim wear although the scar will be longer.

You certainly can use a similar incision and actually place it lower than your orginal c-section scar but given the amount of laxity you describe, it is most likely that you will require a longer incision. C-sections scars tend to average about 1215cm whereas most full tummy tuck incisions average 20-40cm.

Mommyto3,
The same incision as your c-section can be used, but will likely need to be extended to each side. In most cases in patients with c-section incisions, I usually make the incision a bit lower and then excise the entire previous incision. There is no restriction on the amount of excision - it all depends on what is safe for you. Good luck with your surgery.

You describe a fairly typical situation for patients seeking 'tummy tuck' surgery-you've got a stretched out C-section scar, loose skin, stretch marks and excess abdominal fat.
1. Choose a 'goal' body weight you would like to achieve, and try to lose that weight prior to scheduling your surgery. Your result will be much better than if you are heavy at the time of surgery.
2. You did not describe the position of your C section scar, but if it is in the typical low pelvic position, the scar will be removed during your tummy tuck. The tummy scar, however, will be much longer than the C section scar you currently have. It will span the width of your pelvis. This is because of the amount of excess skin and poor skin elasticity (strecth marks) that you have.
3. There are no State regulations regarding 'amount' of skin that can be removed during tummy tuck surgery. However, the operation is fairly standardized amongst surgeons. Most good surgeons will remove just enough skin and fat to give you a nice cosmetic result and place the wound under the proper tension. Note that a tummy tuck is NOT intended to be a weight-loss procedure. Additionally, for safety reasons, liposuction to the abdomen is used sparingly during tummy-tuck procedures.
4. Recovery is variable. It depends on patient's own fitness, motivation and other factors. Plan on taking 7 days off from work. If you do heavy lifting at work, you'll need to be on light duty for a few weeks post-op. Your surgeon can help you sort this out based on your individual employment situation.

When an abdominoplasty is performed in a patient who has previously undergone a C-section the scar is placed below the C-section scar so that I can be removed. Many times after a C-section there is an undesirable overhang of skin at the level of the C-section scar. An abdominoplasty is very effective in recontouring this area and the rest of the abdominal wall. If you are overweight it would be best to get down to within 10 pounds of your ideal or realistic body weight. The more weight you lose the better contouring you will have.In the performance of a full abdominoplasty, an incision is made from one hip to the other. In your case it would be placed below the C-section scar. The incision is carried through the skin and fat layer and stops at the muscle layer. At this level the skin and fat layer is elevated off of the underlying muscle layer. This elevation is continued up to the belly button. An incision is then made around the belly button to keep it in it's normal location allowing the skin and fat layer to continue to be elevated up to the rib margin. Very often tightening of the muscle layer is then accomplished before removing the excess skin. The loose skin and fat layer is then pulled down snugly and the excess skin and fat is then removed. The belly button has not been moved or removed. It is still in it's normal location underneath the skin and fat layer. An incision is made over the belly button and it is pulled up to the surface and re-stitched in it's original location.My simple and illustrated video may help you--learn more about tummy tucks and other body contouring procedures.

If you are less than pleased with your C-section scar, a tummy tuck could remove that scar entirely.  The goal of a well executed tummy tuck is a scar that is just a fine white line, placed below the underwear, bikini line with no scars around the belly button.

"Can you re-open the same incision relating to my c-section?" -  We commonly place the Tummy Tuck incision scar at or just below C- section scars to remove them and improve on them. You will not have two sets of scars.

"Also, is there a certain amount of skin allowed to be removed per patient per state regulations/standards? " - A Full Tummy Tuck will remove all the loose skin off the front of the tummy. The amount of skin removed depends on your weight (less fat under the skin, the more skin can be removed), the placement of the scar (the higher the scar, the more stretch marks can be removed). Unlike Liposuction, there are no regulations governing Tummy Tuck skin removal.

"One last thing- I gained a huge amount of weight lately...(since I turn 32 yrs.old) Is it in my best interest to lose the weight prior to getting surgery?" -  The closer you are to your IDEAL WEIGHT, the better your results will be. Definitely lose the weight.