Is This a Typical Tummy Tuck Scar?

Question

I had a tummy tuck 4/11 and am 2 wks 2 day post op. I am concerned with the corners/edges of scar and height. While I know nothing can be done about the height, it is disappointing.

	Question is: is this a normal/typical look for scar? I feel like a set of pleated drapes. I worry about further excison of 'dogears' as I don't want anymore cutting, stitches & recovery.

Eric Pugash, MD · Answer

Most tummy tuck scars are pleated because the surgeon is stitching together skin edges that are of unequal lengths.

	I always draw a picture of this for my patients so they are not surprised. The pleats will disappear over a couple of months.

	Your scar is a bit high, and this will not change much.

	Stay in close contact with your surgeon regarding the 'dog ears' as these my require revision.

	I have not done a dog ear revision in at least a decade. It is entirely possible to do the surgery in such a way as to prevent these from occurring.

	Good luck!

Richard J. Bruneteau, MD · Answer

The placement and quality of the transverse abdominal incision
is a significant contributer to the final aesthetic result following
abdominoplasty surgery.In this case
your incision is high and the wound was closed with significant gathering.Gathering
occurs when a discrepancy exists between the length of the upper and lower
wound margins.This can sometimes be
avoided by lengthening the incision.This might also help manage residual dogears.Although
your scars are unattractive at this point in time, they should improve with the
passage of time.Wound healing and
scar-remodeling go on for at least a year following surgery.After healing is complete you may be a good
candidate for revisional surgery to improve your scar.In the
interum, it’s essential that you maintain close contact with your plastic
surgeon.With time and appropriate management,
your final aesthetic result may still be acceptable.

Michael Constantin Gartner, DO · Answer

You'll need to wait a few months for the incision to heal a bit more before assessing it. However, you may not experience a significant improvement in the "dog ears". That would probably need surgical correction.

Lewis Albert Andres, MD · Answer

Hello! Thank you for the question!  Your incision will continue to progress - the pleating will resolve and incision likely drop with time and stretching of area. It is common for scars to fully mature for up to a year. In the meantime, there are a few things that may help to ameliorate your incision/scar. The most proven (as well as cheapest) modality is simple scar massage. Applying pressure and massaging the well-healed scar has been shown to improve the appearance as it breaks up the scar tissue, hopefully producing the finest scar as possible. Other things that have been shown to add some benefit, albeit controversial, are silicone sheets, hydration, and topical steroids. These can usually be started at approximately 3-4 weeks postop and when incisions healed. In addition, avoidance of direct sunlight to the incision will significantly help the appearance as they tend to discolor with UV light during the healing process.  Scars will never disappear, but attempt is made to make the finest scar in a concealed location.  Incisions may be revised to lower or conceal better if enough laxity exists. If unsightly scars are still present after approximately a year's time, other things that your surgeon may consider are intralesional steroid injections, laser, or just surgical revision of the scar itself. Hope that this helps! Best wishes!

Stanley Okoro, MD · Answer

Jessica, I totally agree with my colleagues about giving some time for your scar to heal and mature. However, I must ask about the qualifications of your surgeon. As you know, any licensed physician can identify themselves as a cosmetic surgeon and start performing cosmetic procedures such as Tummy tuck and liposuction. I hope your surgeon was a board certified Plastic Surgeon. I personally would have removed the "dog-ear" before the end of the operation. Your dog ear would certainly require revision for optimum outcome.

Pablo Prichard, MD · Answer

Thank you for your post. It is not common for surgeons to anchor the lower incision to the fascia or covering of the abdominal muscles to keep the scar low, however, I do use this technique and agree with it. All the tension on the incision is from above, not below, and thus the scar tends to move toward the area of maximal tension (towards the ribs/bellybutton). This moves the scar higher than desired. I like to keep my scars very low, and feel that anchoring the scar helps accomplish this. The following photo is an example of this.

Tom J. Pousti, MD · Answer

Thank you for the question and pictures.

	At this point in time of your recovery, it is normal for your incision to appear puckered and raised. As the internal sutures dissolve, the scar will relax, flatten, and straighten out. During the first 2-4 months, the incision may look dark, pink, or red. It may take several months before you see a significant improvement in the appearance of the scar. However, with tincture of time, the scar will usually fade and smoothen out. There are many silicone products available, such as Hybrisil, to aid in the healing process and scarring.

	Continue to follow-up with your plastic surgeon.

	 Best wishes.

Rafael C. Cabrera, MD · Answer

I'm sorry to sound negative but I too would be unhappy with this appearance of my incision. I have always been taught the art of plastic surgery is the art of managing "dog ears". this scar is too high and the length mismatch was not handled optimally. luckily, everything gets better.

David Bogue, MD · Answer

To answer your first question: No, this is not a "typical" tummy tuck scar. The placement of the scar is quite high in the center, and the downward direction of the ends is contrary to aesthetic lines giving a strange appearance. Pleating is common and occurs due to closing a longer upper incision to a shorter lower incision. These folds will flatten over time. Dogears are sometimes acceptable in order to shorten the overall length of the scar. The dogear revision is usually a shorter scar than would be necessary if the dogears were eliminated at the original operation. At this point, I recommend waiting until the scars mature as the final scar may not be very noticeable.

Steven Turkeltaub, MD · Answer

All the previous respondents have provided excellent commentary on your results. Your scar, though not very attractive now, will improve with time. However, it is virtually certain that you will require a revision which you may want to wait at least 6 months for. Your scar is also a little too high which can't really be effectively or predictably lowered.

Is This a Typical Tummy Tuck Scar?

Answers (20)

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