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Managing Supra-Umbilical Scars in Abdominoplasty

Q: I’ve heard that supra-umbilical scars or “scars above the belly-button” can impair healing in abdominoplasty incisions.  Can you do anything to avoid this?

A: I have found that often this problem can be circumvented by excising the abdominal scar completely. Often the midline scar can be revised and/or excised and closed, which is a technique often used in body contouring to remove excess skin from the trunk in the vertical direction in addition to the horizontal direction.

Q: Where is the new incision scar going to appear?

A: In general we prefer to place the incision below the bikini line.  However, there are several factors that will influence where the incision will be made, such as: previous C-section scars, where the skin is that will be excised, stretch marks on the belly etc.  We encourage patients to bring a bathing suit in to the consultation to help express to the Surgeon where on their abdomen they would like the scar to appear.  This also allow the Surgeon to dispel and explain any unrealistic expectations.  Most often people are happy with the contour of their abdomen and the placement of the new incision scar.

Q: What are some additional helpful tips to keep in mind during recovery:

•    I tell patients to wait 4 – 6 weeks before going back to the gym or lifting weights.
•    As long as their scar is red they need to wear sunscreen.
•    I don’t advise using any gels or creams on the wound until it is completely healed, about 4-6 weeks.

It is common after abdominoplasty for the patient to experience “early satiety” after meals as there is less abdominal domain. Typically, patients get full during their meals much more quickly. Because of this, patients tend to lose a significant amount of weight post-operatively following their meals. I encourage patients to consume at least 1.5 grams of protein per kilogram of body weight following surgery.

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