Unsightly scars after abdominoplasty - Hourglass Tummy Tuck
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Unsightly scars after abdominoplasty

Unsightly scars after abdominoplasty



The appearance of the tummy can be affected by many factors. The abdomen can become saggy and protrude after pregnancy, weight fluctuations, and even with the natural aging process. Nowadays, plastic surgery offers different options for patients who want to improve the appearance of their tummy. Among the most commonly performed procedures on the tummy are abdominal liposuction and the tummy tuck.

The tummy tuck is the recommended procedure when the patient has poor skin quality and/or distended abdominal muscles. The procedure is a complex one, often performed with the patient under general anesthesia. Its results are permanent if the patient manages to avoid weight fluctuations afterwards.

A frequent concern for patients undergoing abdominoplasty is about the unsightly scars that can occur. In this article, we will discuss about the incisions needed for abdominoplasty and the scars that can result.


Surgical plan for abdominoplasty

The plastic surgeon might recommend a general anesthetic for the tummy tuck. This means that you will be asleep when the procedure is performed. In some cases, the procedure can also be performed with local or spinal anesthesia combined with IV sedation.

There are different types of tummy tucks that can be performed, and the surgical plan and incisions required are different. The tummy tuck can last two to five hours, depending on the amount of skin to be removed. The mini tummy tuck can last one to two hours. When combined with liposuction and/or fat transfer to the hips, the procedure can last longer.

The plastic surgeon will perform an incision from one hip bone to the other following the suprapubic line. Another incision is around the belly button to detach it from the surrounding tissues. When the mini tummy tuck is performed, the belly button doesn’t get repositioned, so the second incision is not necessary and the suprapubic incision is much shorter.

After the incision is made, the next step is for the plastic surgeon to detach the skin from the abdominal wall, all the way up to the ribs to get access to the abdominal muscles. If the muscles are loose, they will be sutured on the median line. The skin is re-draped on the muscles and the excess skin is removed. Incisions are sutured.

When the extended tummy tuck is performed, there will be additional incisions performed on the flanks, mainly over the hip bone on the sides of the body. These incisions are necessary to allow the plastic surgeon to remove the excess skin present on the flanks. This procedure is often recommended for patients who had major weight loss or have undergone bariatric surgery. In this case, the incisions are longer.

Another type of tummy tuck is the hourglass tummy tuck, which entails a combination of liposuction, fat transfer, and the traditional tummy tuck. Aside from the incisions required for the tummy tuck that will be on the suprapubic area, there will also be small incisions on the areas treated with liposuction and also the fat transfer. In a vast majority of cases, these incisions are no longer than 3-4 mm in length.


The period after the tummy tuck

For some time after your abdominoplasty, chances are your abdomen will be swollen and bruised and there will also be some pain and discomfort present. To alleviate the pain, the plastic surgeon will prescribe medication and also antibiotics to prevent an infection from occurring.

It is not uncommon for patients to be unable to walk with a straight back for a few days after the procedure. The plastic surgeon’s recommendation will also be to walk and lie down with your back slightly bent so you don’t put unnecessary pressure on the incisions.

Resuming normal activities often takes place during the first or second week. Most patients will return to work in two weeks, but some might take an additional week off, especially if their work requires more intense physical activities. Strenuous physical exercises are to be avoided for at least a month or two. If you are keen to get back to the gym as soon as you are feeling better, remember to ask the plastic surgeon’s advice before doing so. While resuming exercising might seem like the right thing to do to get in shape and improve the appearance of your body furthermore, doing so sooner than recommended might result in severe complications such as incisions opening that can lead to unsightly scars.


Unsightly scars after abdominoplasty

The scars left behind after the tummy tuck can look quite unpleasant during the first six months until they are fully healed. This is normal and nothing to be worried about. The scars go through a complex cicatrization process that has different stages. This means the scars will be swollen and red, but in time they should look like fine, white lines when the cicatrization process is completed. It might take nine months to a year or more for the scars to start looking more like the surrounding tissues. While the scars are permanent, they should be easy to mask under clothes and even lingerie.

Unsightly scarring after the tummy tuck can occur due to several factors. The main factor is smoking. For patients who smoke, the recovery process can be long and associated with more complications compared to patients who don’t smoke or managed to quit smoking a month before undergoing the tummy tuck.

The general recommendation is to allow at least six weeks to pass since smoking and until getting the surgery to correct the appearance of the tummy. Moreover, the patient should stay smoke-free for at least the same period after the procedure to allow for a normal recovery process. The tissues need proper oxygenation to heal, and smoking can considerably reduce the oxygen in the blood. This can trigger delayed wound healing, skin necrosis, and even unsightly scars.

Exercising too soon after the procedure and not wearing the girdle as per the plastic surgeon’s recommendations can also result in unsightly scarring. Exercising too soon might open the incisions and interfere with the cicatrization process, hence creating scars that are larger or wider. The compression garments or girdle also have the role of preventing unsightly scarring by keeping the area compressed. This means that even if you stretch a bit more than recommended, the incisions won’t stretch and become wider. Always follow the plastic surgeon’s recommendation to have a smooth and uneventful cicatrization process.

There is another factor that can trigger unsightly scarring, and unfortunately, this is not something that can be prevented. We are talking about a genetic predisposition to abnormal scarring. The patient might know about this if he had surgery in the past or if other members of the family suffer from this.

When talking about abnormal scarring, there are two types of scars that can develop that might need additional treatment to be corrected. These are hypertrophic scars and keloid scars. Make sure to go to the follow-up consultations with the plastic surgeon to allow him to monitor the cicatrization process and intervene if abnormal scarring develops. Your plastic surgeon will also tell you what kind of scar you have developed and what suitable treatment plan to be followed to minimize unsightly scarring.



The tummy tuck leaves behind permanent scars, just like any other surgical procedure. The appearance of the scars changes in the first six to nine months after the surgery, and the look of the scars is final about one year after when the cicatrization process is complete. The scars should look like fine white lines that are not protruding from the skin and are similar to the surrounding tissues when they heal completely. Moreover, the scars after the tummy tuck are easily hidden with clothing and even lingerie. Unsightly scars might occur if the patient keeps on smoking, doesn’t wear the girdle, or resumes physical exercise sooner than recommended. A natural tendency to abnormal scarring can also trigger unsightly scars such as keloid or hypertrophic scars.








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