Will An Abdominal Scar Revision Help?

Q: Dr. Eppley, I am interested in abdominal scar revision. I had a panniculectomy done six years ago and an original tummy tuck approximately 11 years ago.  I’ve been unhappy that the scar is so high. As you can see in the photos there are 2 scars. The one on the bottom was from my first tummy tuck. Do you think another surgery to lower the top scar could be done? There’s not a whole lot of skin to work with but low cut bathing suits are what I like to wear. I’m very self-conscious about my scar. Your thoughts are appreciated.

A: My first reaction is that I am stunned that the intervening skin between the two abdominal scars actually lived and not died. That was a very risky procedure from a skin necrosis standpoint. But it did work although the logic of two such displaced scars remains a mystery.

If the goal is to lower the upper abdominal scar (via an upper abdominal skin flap elevation) and bring it down to the lower one, that is not going to be possible. There likely is not enough skin looseness to allow that much downward mobility after having had two excisional abdominal procedures. I do think it is possible that the skin between the two scars can be removed and made into one scar, but that will only happen because some of the closure will come from the lower pubic tissue being elevated. This will then place the new scar about halfway between where the two scars are now. That will not meet your low cut bathing suit criteria. Unfortunately I do not believe your abdominal scar situation can be improved to meet your aesthetic criteria.

Dr. Barry Eppley

Indianapolis, Indiana