TUMMY TUCK   OR SCAR REVISION

Tummy tuck can be performed whether or not there is a pre-existing scar. I usually do these at the time of abdominal liposuction, but occasionally do them alone when there is loose skin but not much fat. I typically remove a horizontal ellipse of skin in about the same area that a low C-section incision would be made (top of the pubic hair). Occasionally a vertical incision is more appropriate. I never make an incision as large as you will see with the full-blown tummy tuck done by plastic surgeons. Those scars are made as part of a procedure in which fat is cut out rather than suctioned. They are hard to hide when wearing a two-piece swimsuit, and are strikingly visible when you undress. I feel that with any cosmetic surgery you should still look good with your clothes off. Scars will never be invisible, but they don’t have to be thick, wide, or dented. Scars of any size, in any location, can be revised using local anesthesia. Ones from c-section, hysterectomy, or other abdominal surgery can be revised during abdominal liposuction. When removing a C-section or hysterectomy scar it is possible to remove up to three inches of skin to produce a "tummy tuck.” Remember that only the skin and the fat layer below it is being cut, so you will not hurt afterwards the way you did after the original surgery. The local anesthetic takes hours to wear off; Advil or Aleve provide sufficient pain control.

If the scar that was removed was thick (hypertrophic or keloid), something will have to be done post-operatively to prevent the new scar from also thickening. Usually this involves jet-injecting the scar with cortisone two weeks after surgery, then every four to six weeks until it stabilizes. The jet-injector sprays a fine high-pressure jet right through the skin and works much better than needle and syringe. In fact scars that are thick but not too wide do not always have to be removed; many can be managed by jet–injecting them with cortisone or bleomycin.