Avoiding Common Errors Made in the Tummy Tuck and Tummy Tuck Revisions Part 1
By: Dr. Kenneth Hughes
A high scar for a tummy tuck can be lowered by removing more skin below the scar and pulling the scar lower. However, this is ineffective for most revisions. Most of the time, this revision requires re-dissection of the tummy tuck flap higher to the level of the xiphoid process and the costal margins to allow greater recruitment of the tissue to lower the scar. Although many plastic surgeons may refer to dissection to the level of the xiphoid process, it is rarely done due to the precise and careful dissection required.
An asymmetric scar can be rectified by using one of the two revision methods above depending upon the degree of asymmetry. Raising a lower portion of the scar is also a method that may be appropriate.
True dog ears can be avoided in the vast majority of cases by removing the exact area of tissue and pulling the flaps together at the most favorable angles. However, many patients want the smallest scar possible. If a patient has extensive skin laxity that extends well beyond the normal tummy tuck scar, the surgeon should not chase the scar another 3 or 4 inches to try to avoid a dog ear. Many of these slight dog ears resolve over time.
Sometimes not enough skin and fat are removed or the patient has a particularly lax skin envelope. This revision can involve removing more skin and fat at the bottom while maintaining scar position or lowering scar position if necessary. Sometimes, the laxity is so great that repeating the entire tummy tuck dissection is the only reasonable option.
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Dr. Kenneth Hughes, Tummy Tuck Expert
Tummy Tuck Revision Expert, Los Angeles