Hi I had a full tummy tuck/diastis repair 10 months ago due to large babies, I am rather thin with a lot of remaining loose skin. when I sit down it is unsightly. My Surgeon,(board certified BH Plastic surgeon), has recommended a vertical midline scar to remove 4 more inches of skin which will also address the stretchmarks that are in that are, If the skin was just pulled down the stretchmarks would just be relocated and it might not rid all the loose skin. Is this a good choice for me? Thanks!!
Vertical Midline Scar, Tummy Tuck Revision for Loose Skin Options? (photo)
Doctor Answers 8
Tummy tuck revision
You posted this question a few days ago - thanks for the photos this time, it really helps!! You do have some extra skin above the umbilicus which is suboptimal but not your surgeon's fault. There are two ways to address it: either redo the whole TT, reundermine all areas and drape the skin DOWN AND OUT rather than down and in as is usually done. This can tighten the skin better that what you have now. The other thing is that anatomically you are taller than wide and in folks like you, there is often more skin to remove side to side (vertical scar) than up and down (horizontal scar). This would give you the tightest flattest result but with a very visible scar.
I would maximize the downward pull
Thank you for the question and photos. What I see is residual laxity that would be improved with a revision tummy tuck utilizing your horizontal incision. Since you have a vertical scar below your belly button you may also to tighten the abdominal skin in a horizontal direction at the same time but only after the vertical reduction of laxity is corrected.
All the best,
Dr Remus Repta
Revision abdominoplasty choices
A vertical infraumbilical scar is often not needed. Redraping of the tummy tuck may loosen some of the skin laxity and you will likely only have an additional 1.5 cm vertical scar from the old belly button incision on your abdominal flap.
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Loose skin above the umbilicus post tummy tuck
Thank you for your question and the photos. I think from cosmetic perspective is to have the tummy tuck revised with more undermining and better redrapping. A vertical scar may take some of the wrinkles and redirect others in a different direction.
Vertical Scar for Revisionary Tummy Tuck?
Thank you for the question and pictures.
Although your plastic surgeon's recommendation will likely remove a significant amount of redundant skin, you will need to decide whether this improvement is worth the presence of a vertical scar. This will be a very personal decision that only you can make.
Will revision tummy tuck help my loose skin?
You present a difficult problem because it is obvious that you didn't stretch very well after your first full tummy tuck procedure. In order to best try and maximize your results, I would suggest revising the entire procedure with a combination of a longer horizontal scar and a verticle scar as well. A small, well placed belly button which pulls the skin in tighter around it would also help as well. I would recommend that you wait until after one year from your first procedure to allow the scar tissue to soften and the skin to maximally tighten. Hope this helps, good luck.
Tummy Tuck Revision
Thank you for the photos this time, it really helps. I agree with Dr Rand wholeheartedly. Looking at photo 1, I see many horizontal wrinkles/stretchmarks above the belly button, which would suggest that just redoing the downward pull of skin toward your horizontal scar would be effective. However, I suspect that your skin does not stretch much, based on the location of your vertical scar (which represents where your skin was originally attached to your belly button.) Also, as you said this would only relocate your existing stretchmarks. A vertically oriented excision would remove most of your stretchmarks and tighten skin in a perpendicular vector, but it would come at the expense of a vertical scar that would span from your horizontal scar to near your sternum. We can't guide you into one direction or another, so your decision will have to be between you and your doctor.
Best of luck!
Tummy Tuck Revision
Based on your pictures, you have two choices. A slightly longer horizontal incision (the one you already have) to tighten your skin or a vertical (up-and-down) incision. My suggestion would be the longer horizontal incision which should be able to adequately tighten your skin and give you a very nice result.