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Tummy Tuck with Prior Abdominal Scars-Difficult Case Report

By: Dr. Glenn Lyle


preop abdominoplasty

Image shows patient with prior open hernia scars

preop abdominoplasty

Image shows patient with prior open hernia scars

Abdominoplasty in patients with prior abdominal surgical scars can be challenging.  Some scars can alter the proper blood flow to the healing incisions and lead to wound healing problems and tissue necrosis.  Midline scars of the lower abdomen can be completely eliminated in most patients while upper abdominal scars, above the umbilicus cannot be eliminated but may be transposed to the lower abdomen. This 23-year-old mother of 2 children had a large umbilical hernia repair performed in the past with a piece of mesh.  She had a significant scar of the upper abdomen and almost no bellybutton.  She could feel the sutures from the mesh placement through her thin abdomen.  She desired abdominoplasty to improve her contour and scarring

post op abdominoplasty

Note: The upper abdominal scar has now been relocated to the lower abdomen

Pre-op oblique-Note depressed

Patient had prior complicated open umbilical hernia repair with resultant scarring

Post operative oblique view

Note depressed scar in the upper abdomen is essentially removed

She underwent full abdominoplasty and had a significant diastases that required repair.  In fact patients with large diastases will often have an associated umbilical hernia and mesh placement alone will not address the diastases.  Her procedure was quite challenging as the blood supply to the umbilicus was marginal but she had a successful outcome.  Her depressed upper abdominal scarring Was nearly eliminated or improved.  She still has scars but there in a much better location.  Her scars will improve with time and the use of silicone gel products.

Intraoperative photo of diasta

Patient had a very large diastases rectus and almost no umbilicus after previous open hernia repair

* All information subject to change. Images may contain models. Individual results are not guaranteed and may vary.