A mother of 2 in her mid 40’s who is bothered by bulging and rolls of her stomach after pregnancies. She feels like she is 3 months pregnant. She had polyhydramnios with her second pregnancy and was more severely stretched than typical. She has had some problems with hypertrophic scarring with her c sections. She is 5’4” and 136 lbs and is shown before and again, 5 months after abdominoplasty. An umbilical hernia was corrected by her general surgeon at the same time. Her case illustrates some typical challenges and how I like to address them. Her skin laxity is not at severe as her muscle stretching but is still present. But not enough to fully remove the vertical slit of the skin that was previously around her umbilicus. One option would be to put her entire horizontal scar much higher, where we see the vertical slit scar. This is rarely satisfactory, in my experience, because she now would have a visible scar across her entire abdomen. Instead, as I have done in her case, it is better to place the main scar low, in the “thong” position where is can be covered by most clothing styles and accept a small vertical scar in the lower abdomen as a necessary tradeoff to allow us to tighten the abdominal skin. I have formed a periumbilical hollow by sculpting the fat around her umbilicus as well as a “champagne groove” by shaping the fat in the midline above the umbilicus to give the abdomen an even more beautiful appearance after her surgery, not just tighter. She was surprised to find that she has dropped 4 dress sizes after her surgery, and loves being able to reach in her closet an grab some clothes without worrying what she might need to wear to hide the buldge. Scars will typically continue to improve for 2 years after abdominoplasty- her main scar is hidden under the thong line. The vertical scar will continue to fade and improve over the next 18 months. Because of her history of unfavorable scarring, I have started her on taping for the first 6 weeks and then topical silicone.
Cosmetic & Plastic Surgery Specialist
"I treat my patients like I would treat
- Jonathan D. Hall, MD, FACSmembers of my own family."
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