What causes crooked tummy tuck incisions/scars?

Tummy Tucks are usually designed to result in a nice smooth,even scar, but there definitely can be factors about the patient or the healingprocess that influences how things turn out. One issue is the anatomy of theabdomen to begin with. Not everyone starts out even or symmetric. Scoliosis orscars from previous surgery can greatly impact the abdominal contour and changehow the tissue responds to the ‘injury’ of surgery. Issues during the healingprocess can also alter results. Infection can tighten scar tissue and distort dehiscenceor popping of stiches can change how the final scar heals. You can even losethe blood supply to some of the tissue causing it to die which obviously wouldchange the final outcome. Some of these things are influenced by surgical technique,but more often it has to do with how the patient behaves during the healingprocess. If you are not careful with your dressings and drains, it is easy tocontaminate things and increase the likelihood of infection. If you do too muchactivity during the early healing process, you can pop stitches or causebleeding and excessive swelling. Smoking especially impairs the blood flow tothe tissue and can cause it to die (even second-hand smoke). The best way toavoid these problems and achieve a beautiful result is to follow theinstructions of your surgeons very carefully and ask questions if something isnot clear. That way you and your surgeon can work together to you the bestresult possible.

      The key is how the tension is managed at the end of the operation.  I spend about 30 minutes on the tummy tuck itself and another 1 hour making sure the incision is as perfect as possible.Kenneth Hughes, MDLos Angeles, CA

The final location of the incision is measured precisely by the surgeon.  The final location is generally very good but healing can be unpredictable and the location may not be symmetric .

Some irregularity of an abdominoplasty incision
is not infrequent and is based on healing and the anatomy that you present
with. Most surgeons suggest the markings be performed before surgery in a
standing position because this will allow the greatest chance of an even
contour and final scar. Sometimes adjustments have to be made in the operating
room for tissue irregularities and that can sometimes result in a scar that is
not perfectly even or symmetrical.

The location of the scar can be influenced by patient asymmetries (scoliosis) or prior surgery.  These should be pointed out prior to surgery. Occasionally, it is surgeon error, but these are usually minor inconsistencies. All tummy tuck patients have got to be comfortable with the presence of a scar because that is necessary for the operation. Make sure you look at the SHAPE after surgery and remember that the scar is concealed by clothing most of the time anyway. There are many scar therapies out there but even so, a small percentage may go on to scar revision. You need to understand these points before going forward with surgery. Good luck!

A abdominoplasty or tummy tuck incision is always straight in the operating room. The main factor that leads to some asymmetry is tension along the incision. Most surgeons place multiple layers of stitches (deep to superficial) to disperse this tension which allows the skin incision to remain perfectly symmetric. So surgeon technique absolutely plays a part in incision quality.

Thank you for your question.In some cases the pole of your abdominal muscles and upper trunk can put more pressure on one sideand cause an uneven pull on your tummy tuck scar.  However if you're referring to areas of bunched skin and lumps and bumps it is because the tissues have to be gathered during closure.  Typically with time the gathering pulls out and flattens.  Please express your concerns to your plastic surgeon.