This patient had more muscle laxity that skin laxity. Here she is at 3 months with a very flat tummy. Her scar will fade with time.
I just love doing tummy tucks because this procedure allows me to tighten skin, fix muscle position, remove fat and improve a belly button in one operation. Usually this can be done with an incision that is admittedly quite long but is where the sun doesn’t usually shine. But sometimes, maybe 10% of cases, it is necessary to leave a scar in the lower mid-line. Sometimes a patient really needs a full tummy tuck to correct muscle separation but doesn’t have quite enough skin laxity of remove all of the skin between the pubis and the belly button and in those cases a “t-incision” is necessary. In most cases, I have a pretty good idea before surgery if I am going to need a t-incision but once in a while I cannot quite get that skin to stretch enough and have to leave a t-incision without prior warning to the patient. This occurred recently and I had a husband hopping mad at me for the extra scar. The alternative would have been to make the abdominal skin closure so tight that the patient would never be able to stand up straight again or position the really long horizontal scar quite high which would probably look worse than a nicely healed t-incision.
These intraoperative decisions are very, very difficult and sometimes, quite frankly, agonizing. I am hoping that this particular patient heals well and her vertical scar becomes a non-issue as is usually the case. And sometimes I just wish patients and their families could spend a day in my operating room clogs. It’s not so easy!
Thanks for reading and letting me get that one off my chest! Dr. Lisa Lynn Sowder
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@lisalynnsowder
