16 days or 16 years it's just not good enough
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.
Is This a Typical Tummy Tuck Scar?
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.
Is this a typical tummy tuck scar?
I am always torn between trying to reassure patients who ask questions on this site and being blunt and completely honest. These do not look like any tummy tuck scars that I place on my patients. I do not see the pleating, I do not leave large dog ears, and I do not turn the scar downward at the ends to deal with a dog ear ineffectively. The planning of the tummy tuck scar is a critical step in the procedure, and if properly planned, I think that many or all of theese problems can be avoided. So, I cannot say that this represents a typical tummy tuck scar that I create in my practice. That being said, your scars will improve in some ways over many months, and after 6 months or sao you could consider a scar revision...get some second opinions.
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.
At 16 days post op, tummy tuck scars can sometimes appear pleated from the stitches. This situation will probably improve significantly over the next several months. Although your incision appears somewhat higher that average, this too may improve to some extent as you skin relaxes. Occasionally, to achieve a better result one could consider revisionary procedures such as the tailoring of "dog ears" (puckered skin at the end of an incision). But, I would allow at least 6 months to pass before considering any revision. By that time, you may be surprised at the improvement that has taken place by allowing the incision to heal and the scars to soften and mature.
The typical tummy tuck scar
The ideal tummy tuck scar is low along the pubic line sweeping out to the side such that it lies below the under-pant line covered by most bathing suits and low cut jeans. Often the line will begin at the level of many C-section scars. After full healing there is no pucker or ripple and no 'dog-ear' at the end of the incision line. Your tummy tuck line is a bit high, though over time the pleats or ripples and raised edges will flatten, and if your heal smoothly your result can be very good. The 'dog-ears' will likely need an office revision, but don't give up and give it more time.
Best of luck,
Unhappy with Pleating at Corners of Tummy Tuck Scar
I fully understand your disappointment. I want to assure you that you that at 2 weeks after surgery you are way too soon to draw a defintive conclusion and that the scar will improve significantly in the coming months.
You have to understand the reason for the pleats. If you are familiar with hemming this will be much easier. As your abdomen was stretched by pregnancy and obesity the skin around the belly button was stretched a lot more than the skin of the groin (which was protected from stretching by your pelvic bones). As a result, the ultimate stretched skin had a spin top shape rather than a cylindrical shape. After removing the loose skin overhang as part of the tummy tuck, the surgeon is commonly left with a longer segment of skin on top that needs to be stitched to the (protected) shorter segment on the bottom.
This has two solutions: 1. prolong the incision on the bottom and have two even ends but a much longer scar OR 2. Gather the longer upper wound and stitch to the bottom creating TEMPORARY pleats BUT keep the scar shorter. Your surgeon and most surgeons would opt for choice 2. In the vast majority of cases, the pleating smoothes away and in the uncommon cases that "dog ears" need to be revised, it is a short office procedure with a MUCH shorter scar than you would have had if choice 1 would have been done.
Cheer Up! It WILL look a lot better than it does now.
Peter A. Aldea, MD
Scars from Tummy Tucks- Shape Trumps Scar!
Scars from tummy tucks generally fall in the crease that forms in the lower abdomen when seated in a chair. The length of the scar, not surprisingly, is directly related to how much skin is to be removed. The more skin to be removed, the longer the scar. Attempts to really shorten the scar end up causing problems of pleating, irregularity, and "dog ears" (cone shaped prominence at the end of the scar). In most cases, the best results are obtained from using an adequate scar length, and, in my opinion, it is better to get a smooth shape rather than a shorter scar, all else being equal. A well placed longer scar is more acceptable than a shorter scar with suboptimal results! Hence the oft exclaimed saying "Shape Trumps Scar!" In plain English, getting a good shape is more important that getting a shorter scar, everytime!
Patients who have suboptimal results may have significant improvement of the overall results with a well executed scar revision (sometimes with a concurrent liposuction touch up). The timing and extent of your scar revision will depend on several factors which must be discussed with your surgeon.
Not a "typical" tummy tuck scar
Even though you are only 2 weeks out and have lots more healing to do, I couldn't say that yours is a "typical" TT scar. I am confused by the downturned edges and you look like you will need dogear excisions because these generally don't settle away with time.
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.