Is there any way to improve/remove the vertical crease I have been left with following my tummy tuck? (Photo)

Question

After losing 77 pounds and having excess skin I am 17 weeks post op full tummy tuck, lipo to upper abdomen and muscle repair (15cm gap) My healing has been without complications however I am disappointed to be left with a deep vertical crease that hides my belly button. I realise that this is better than an FDL vertical scar but is there anything that could be done to improve it? Would more lipo help? Will it improve with time? Or further weight loss? Or exercise?

Ajay Mahajan, MD, FRCS (Plast) · Answer

Considering what you started off with, you have had an excellent result. You are certainly better off giving it some more time to see how things settle. Massive weight loss patients often need an extended (Fleur de lys) andominoplasty that results in an additional central vertical scar. You have done well to get way without this scar and the compromise might be to have a little lax tissue in the centre.

Dean Trotter, MBBS, FRACS · Answer

Well done on your weight loss and your surgical results.  I think you have an excellent result but I can understand your concerns regarding the vertical crease you now have. This crease occurs because the horizontal excess of skin and soft tissue that you developed with weight loss is not easily removed via a standard tummy tuck - in fact the muscle repair creates even more horizontal excess. To correct the crease without a vertical scar I suggest a combination of liposuction and fat grafting.  These can improve the crease to some extent but are unlikely to correct it completely - to do so would need a vertical incision as you point out, and I agree with you that this is not aesthetic as your current outcome.I don't think further weight loss or exercise are likely to make much difference.Time is likely to help but it is unlikely the crease will disappear.I suggest you discuss your concerns with your surgeon.  If further surgery is being considered I think you should wait at least 6 months from your tummy tuck before making a final decision.Kind regards,Dean

Charles Nduka, MD · Answer

You do have a great result from the surgery. The horizontal crease may be improved by having fat graft but it may only reduce the crease.

Barbara Jemec, MD, FRCS(Plast) · Answer

You have an amazing result, and well done for keeping the weight!
Unfortunately you can only get rid of the vertical crease by exchanging it for a scar, so I personally wouldn't. You could look into Thermage but I am not sure it would do enough.
You look great!

Millicent Odunze Geers, MD, MPH · Answer

From your preoperative photos, it appears as if you had both horizontal and vertical skin excess of the abdomen. The horizontal excess was treated with the traditional tummy tuck. The remaining vertical excess can be addressed with a vertical excision of skin, but it will leave a vertical scar. You may want to consider a 6 to 12 month wait before revision as you are still early in the healing process and will experience continued skin changes. The other options you mentioned will not treat the vertical excess. If the vertical excision with the resulting scar is not palatable, the result you have now is the result you will have to learn to accept. Your overall contour is vastly improved though! Be sure to share your concerns with your plastic surgeon.  Best of luck.

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