Dr Glenn Lyle, Board Certified Plastic Suregon in Raliegh, NC, has seen many patients who tell him that they would never wear a bikini at the beach or pool because they feel embarrassed about their tummy appearance. In many cases their pregnancies took a toll on their bellies. But for some women prior surgical scars – especially poorly healed and depressed scars – make them feel so much worse about their tummy appearance.

When people have a tummy tuck, in clinical terms -known as abdominoplasty, part of the lower abdominal skin is removed to create a smoother appearance. Frequently removing this skin will get rid of surgical scars, in particular scars from appendectomy, hysterectomy, or C-section. Of course an abdominoplasty results in a new scar from hip to hip, but it is intentionally located very low on the belly so it can be hidden by many styles of bikini bottoms, underwear, and low cut jeans or shorts.

From a surgeon’s perspective, abdominal scars can present a challenge and special care must be taken when approaching the previous surgical site during the dissection of the abdominal wall.  An unexpected hernia may be encountered where the scar may be heavily tethered to the abdominal wall so and experienced plastic surgeon-will take all of this into consideration and must be prepared to deal with an opening into the dominant contents.  Although this is pretty uncommon, potential for injury intra-abdominal contents is possible.  

Dr. Lyle attained board certification in general surgery prior to completing his plastic surgery training in has a great deal experience in treating abdominal hernias so is more comfortable when these are encountered.  Fortunately, most scars encountered in the lower abdomen are not associated with hernias.

One particular type of abdominal scar that can present problems is a vertical scar extending from the belly button to the pubic area.  These are often tethered to the midline and had a depressed appearance which is very unsightly.  When they are depressed like this from previous C-section or lower abdominal surgeries, they can often be tethered to the midline fascia and hernias may be associated with them.

Upper abdominal scars can present more challenges.  The old-fashioned gallbladder scar from a cholecystectomy -call the Kocher incision is often from just under the lower rib margin across to the lateral right abdomen.  These scars generally cannot be removed and present problems with blood flow to the tissues below them which are pulled down to the pubic area during abdominoplasty. This previous interruption of blood flow can create areas of ischemia or loss of blood supply to the midline abdominal wall and can have disastrous consequences especially with large, long scars.  Plastic surgeons must be very mindful on these cases and in some cases need to modify the abdominoplasty or do a mini abdominoplasty with liposuction to avoid major wound healing problems and wants to abdominal skin.

Smaller upper abdominal incisions such as laparoscopic scars usually present no difficulty but often have small hernias underneath which need to be repaired.

In these pictures, you can see this 50-year-old woman with noticeable scars from the removal of an ovary and three C-sections. Although very fit, she would never wear a two-piece bathing suit that showed her belly. During surgery, those scars were removed with her lower abdominal skin. After surgery, she had a much smoother and flatter tummy appearance.  Her new scar from the abdominoplasty is hidden with her underwear. She recently returned for a post op appointment and was so happy with her results that she wore a bikini while on a trip to the Caribbean!

FAQs

1.Can my C- section scar be removed?

Yes- most tummy tucks start at or below the C section and the new incision will remove the scar. However- you are trading it for a new scar but usually flatter.

2. Will my old belly button piercing be removed?

Yes- in almost all cases unless it is a mini- tummy tuck.

3. Will stretch marks be removed?

For a full tummy tuck- the stretch marks below the umbilicus are generally removed. Those above the belly button are then located below and the tummy is tighter so the stretch marks remaining are less noticeable.

4. How can I make my tummy tuck scar look better?

Incisions are treated with prolonged paper taping and silicone tapes or treated with creams. For problem scars, lasers may be effective to reduce color. 

5. Can I get rid of a tattoo?

If the tattoo is below the belly button- it can be removed or partially removed. Your surgeon should be able to predict what portion of the tattoo will be removed. In many cases, only part of the tattoo is removed, and a tattoo artist may have to “re-do” it.

Looking to get rid of ugly abdominal scars?  Reach out to Lyle Plastic Surgery and Aesthetics Center at (919) 307-8585 to arrange a consultation with board-certified plastic surgeon Dr. Glenn Lyle.