Las Vegas Abdominoplasty - Ask Dr. Garcia Library - Page 1

NOTICE: Las Vegas Abdominoplasty: Ask Dr. Garcia is intended for educational and discussion purposes only. It does not constitute a formal medical evaluation nor consultation. No doctor-patient relationship has been formalized by this communication. If you desire such, please feel free to call and schedule an appointment. Otherwise, please be advised that all information that has been given here should be cleared with your primary care physician before changing or instituting any therapy. Explanation of off-label use of substances may be discussed here in but does not reflect an endorsement nor promotion of such off-label use. All responses regarding Las Vegas Abdominoplasty are done personally by Julio Garcia.

hello dr. Garcia, 10 months after full abdominoplasty i am still hollowed between legs and sides above with an raised pubis and a waist also hollowed between stomach and belly, weight gain does not help, there is no fat any more on the waist, my waist is as tiny as it is not normal. i am a petite figure, pants dont fit any more, hips are larger then before and then with all the hollows as i described, it is completely abnormal, would this get better with masages from a specialst to reduce the internal scar tissue, what can i do? thanks for reply
Answer: you might need some fat injections to give you a better contuor. The massages might help a bit. Best of luck. JG 3.8.12
I am considering abdominoplasty, I have lost over 50lbs since have twins & a single child & I have too much skin! My question is this; I have a small hernia from a c-section type surgery removal of a large cyst. Can these two surgeries be done together? fixing the hernia & a tummy tuck? or do I need to fix the hernia first? and if I do, how long should I wait before a tummy tuck?
Answer: yes, those surgeries can be combined. Best of luck. JG 3.2.12
Hi dr Garcia, Is it tru that after abdominoplasty with liposuction from certain areas, pubis, hips and stomach middle line, the body stores fat in other places whithin one year like arms , breasts or back , this even when the weight stays the same. I heard that the body needs a certain amount of fat and that if fat is removed from certain areas it will go to other areas to keep up with the amount that it needs, resulting in deformed body composition. to less fat in some parts and too much in other parts. Can it go to the face as well ? What can be done to prevent or to correct this. thanks for explanation.
Answer: the fat removed with liposuction is permanently removed, so if you continue to eat above your minimal daily requirement of calories, then you will store fat, and since the original first places for the fat to go to are gone, the fat will find a new place to be stored. It only happens if you over eat though. Your weight staying the same means you actually gained weight since you lost fat from the liposuction, so there was a fat gain you have that has not been appreciated. The body does not need a certain amount of fat. In some cases, after menopause, the body is low in estrogens and your body can make you can gain intra-abdominal fat in an attempt for that fat to make estrogens, but it will not cause fat gain in other areas. Fat gain in the face is weight controlled, not influenced by liposuction.I think you need to get your body fat tested and then start on a smart eating program and exercise program and lose some fat while gaining muscle. All the best. JG 1.26.12
dr garcia, i just had a scar revision from a bad abdominoplasty scar. I have the impression that a piece of skin, where there was scar tissue is loose now and my belly seems bigger looser then before, do i have to wear a compression garment again ? is this normal i dont fit in my clothes at the moment. I also had a new breastuplift with replacement of implants, second time, i have less pain, but my breasts have the same size as before although they were replaced by smaller implants. Could this be swelling again, i dont feel that much swelling, why do i have less pain then the first time, is there something wrong, less sensation ??? Thanks for reply.
Answer: they likely had to release the surrounding tissue on the tummy to allow the wound edges to come together, so that explains the scenario, but that will all settle down with time. As to the breasts, I think it is likely swelling too, which will also go down in time. All sounds normal for what you went through, just got to hang in there. JG 12.28.11
I am presently 5 months post-op following a full abdominoplasty w/liposuction, and have two concerns. First, I have had a band of very firm tissue (internally) at the suture line, which has resolved everywhere but at the mons pubis. My surgeon believes it will continue to improve with time, but the mons remains puffy and the firm tissue seems resistant to go away completely. Assuming this firm area will eventually soften, will this relieve some of the puffiness of the mons (which I believe is due to some fluid retention)??? Second, and probably of greater concern is that at approximately 8-9 weeks post-op, I foolishly attempted to lift a 40-lb bag of dog food into a shopping cart, and felt searing pain in the left-midline upper abdominal area. My surgeon had told me that the rectus abdominis was significantly separated to the far lateral sides of my abdomen due to years of obesity and two pregnancies, one of which was a twin gestation, and that he did some “heavy suturing” to reconnect the two sheets of muscle. I discussed my lifting ‘injury’ with my surgeon, and he seems to feel that since there is no bulging or evidence of internal bleeding, that the muscle will heal normally. However, it has been over 3 months since I injured the site, and I continue to have considerable pain with the area very sore with even the slightest pressure. I am unable to sleep on my side without a pillow firmly tucked against my upper abs, or without my abdominal binder in place. Although I trust my surgeon and am overall VERY pleased with the aesthetic results of the surgery, I was hoping you could provide some reassurance that this will heal and will eventually stop causing me pain. Thank you so much for your time.
Answer: I believe as the firmness in the mons area softens, it will also shrink in size. Edema of the mons can take a long time to resolve. As to the pain after the lifting, if the fascia where the sutures were placed partially tore, that can take a number of months to feel better due to the constant movement and function of the muscle. I agree with your surgeon`s perspective and that it will likely go away and heal without any significant problem. Hang in there and I wish you the best. JG 12.6.11
HI Dr G Hope this finds you well. I`m now 6 weeks post op from Abdominoplasty, healing going well my incision is a fine pale line but just underneath my incision line I am spitting a few staples, my surgeon used these not to close the skin (this was glued) but to close tissues. I have been spitting one for about 4 weeks that has been painful and has come to what looks like a big red pimple,the others are just a bit red but are not painful. My surgeon is a long drive away and has told me it will pop out on it`s own and when it does just to treat it with Iodine and loose dress it . The thing is it has been ages now and though it looks like it will pop should I wait ,will it do any harm for me to wait for me to let them pop on their own....or should I go and get them taken out by the surgeon?but will it take many trips. Do they need to be right near the surface of the skin to get them out? Thanks Dr Garcia in advance, great site. Just wish you lived in my country!!
Answer: I think in order to get the best scar, a trip to the surgeon is warranted, and they should be able to remove all of the problem staples in one setting. All the best. JG 7.13.11
About how long does it typically take internal dissolvable sutures to dissolve (abdominoplasty)? And about how long does it typically take for the hard, stiff quality of swollen tissue to soften? 4 wweks? 6 weeks? Thanks very much for your kind help, Dr. Garcia.
Answer: depending on the type or brand of absorbable sutures, it can be 6 weeks to 3 months. As to maximal softening of the scar tissue, most of it is in 3-6 months but there can be continued changes for up to one year. JG 7.1.11
Hi Dr Garcia I had a full Abdominoplasty 3 weeks ago with muscle repair, the surgeon removed 2 LB of skin , lipoed very little out for contouring as I had very little body fat at 122 LBs and said I had slight muscle separation which was corrected. He said my muscles were very toned as I am an elite marathon runner. I am a great shape and he is known for pulling you very tight, I`m only just getting upright. The slight concern I have ,and I do understand it is very early in the healing is that I have a very deep grove/crease that runs up from my belly button vertically up to my bra band. He did the quilting technique so I had no drains and very little swelling , I can see my muscles now like I have done a million sit ups. He said it will flatten out somewhat but it is good to have a crease there as it really gives definition to the abs...to be honest at the moment it looks odd and if I really stretch the skin out flat with my fingers the grove is still pretty visible. I was told by the nurse that this is all due to the quilting stitches that need to dissolve. Could my compression garments contribute to this? Have you heard of this being a byproduct of this technique? Could it be down to my toned muscles being brought together and be permanent? sorry for all these questions so early but you have always been an honest opinion and a star! Thanks Dr G
Answer: do not think the compression garment is making it any worse, and with quilting sutures, it is common, I see it my patients, especially thin ones. In time, as the sutures dissolve and you start moving around, that crease will improve, just takes some time. Hang in there. JG 6.23.11
Years ago I had liposuction of the abdomen. I am unhappy with my rippled belly. I weigh 123 and am 5 ft tall. Is it possible to have a short scar abdominoplasty to improve the appearance of the abdomen or is the long scar procedure usually required? I have a current scar from a hysterectomy.
Answer: if the skin is loose only below the belly button, it might be able to be done with a relatively short scar, if there is loose skin above the belly button, then those scars will be longer. Best of luck. JG 6.1.11
2 months after abdominoplasty still this pulling sensetion inside, how long does it take to feel normal again ? Above the pubis area there are some hairs that are growing inside the skin, creating some bulging on several places, is it nessesary to open those spots and remove the hair. thanks
Answer: it can take 6 months on rare occasions, all depends on how much skin was removed and how much adherence there is of the skin to the underlying tissues. I think seeing your surgeon to allow those hairs to be lifted out is the best option. I wish you the best. JG 4.25.11
Dr. Garcia, thanks for reply on the abdominoplasty question. What do you mean by if the skin on the upper abdomen was tick ? IDo you mean fat in that area. My skin itself is not very tick, i have thin skin, could it be the streching of the skin , making my previous curves less prononciated and creating a straither silhouette with a fuller waist. Second question, seems that after the surgery, my fasting glucose level is much higher then before, is this related to the narcose,or something else ? Thanks again.
Answer: I meant to type, thick,so yes, fat underneath the skin. Tightening of the skin should not make you lose your curves. At times the fasting glucose is higher as you are not as active and not burning as many calories. Best of luck. JG 2.21.11
Dr. Garcia, A few days ago i had an abdominoplasty and now it seems that first i have a big belly, a fatty elevated pubic area, and also my waist is like 4 inches bigger then before. Is this because the fat and skin that was on the stomach area it pulled down, making my waist that much bigger, also the skin was streched a little forward to tighten the loose skin on the sides, does all this contributers to bigger waist and belly ? I also had a breast lift with replecement of old implants, the old 225 cc implants were replaced by 200 cc implants, however my breast are bigger then before ? How much bigger in cup size does 200cc ? Concidering a tiny frame on a tiny person ? Would it be possible to remove the implants and replace them by smaller ones after a few days ? Does that affect the breast lift ? Thanks for answer.
Answer: hard to say without seeing you before, it could be swelling, but if the skin of the upper abdomen was thick, and it was pulled down, it might be that also. The breasts are also swollen at this point. The difference from 200 to 225 would be less than a 1/4 cup. I think there are not many sizes smaller than what you had placed and a breast implant will not lift a breast, especially going smaller. JG 2.20.11
I had a mini tummy tuck 10 years ago, it did not do much, certainly not for the stomach area. As my skin is quit loose i consider a complete abdominoplasty. Can the same scar be used ? In that case the skin would be tight but it should loosen up a bit in a year maybe? Other solution to avoid another scar and tighten the complete area ? There is loose skin in both directions. Thanks.
Answer: the location of the scar will be the same but likely longer, and there is always some loosening of the skin with time, the older one is, the faster the loosening of the skin can occur too. I am afraid there are not other viable and reliable options to tighten or remove abdominal skin, sorry. JG 1.7.11
Dr. Garcia, First, thanks for answering all these questions. Your site is a wealth of ihformation and I appreciate your candid answers. Over the past year I have lost 53 pounds through diet and exercise. I have pretty good muscle tone and I am in the best shape of my life with one exception. I have a small, saggy belly (Looks like a balloon that deflated over time over time) and my belly button needs stretched horizontally because of the extra skin that has melted in to it. I am not interested in a full tummy tuck as I have good muscle tone and not a lot of extra fat. I am 5`4 and weigh 137 pounds with a muscular build. I would love to wear a bikini to the pool but am very self conscious of my belly. Would a mini tummy tuck leave the large scars I have seen on some of the photos. I already have a C section and gall bladder removal scars, so not too crazy about the idea of having huge scars. What is the cost difference between full and mini abdominoplasty? Thanks!!!
Answer: firstly, congratulations on the weight loss using the best method out there. Whether a mini tummy tuck will give you a good result depends on how much loose skin there is above the belly button. A mini tummy tuck will not tighten any skin above the belly button, so if ther is laxity there and a full tummy tuck is not performed, then the lower part will look smoother and the part above the belly button will look different. Hope that helps differentiate what you might need. All the best. JG 9.29.10
Dear Dr Garcia. I`ve booked a full tummy tuck with muscle repair in the uk for July. I live in the Middle East, it`s an 8 hour flight back. I`ve just received my surgeons instructions and am shocked to find he says I should be in the Uk for 4 weeks after and 4 weeks before surgery to minimise the risk of DVT. He`s sent me an article indicating that the risks of DVT are higher if you`ve flown for more than 3 hours before and after an abdominoplasty. I was aware of the risks involved after surgery, but have never heard of a requirement to travel so far in advance of the surgery. Is it really necessary?
Answer: I think that is a little extreme, I think a few days before and 2 weeks after is reasonable. JG 3.30.10
Hi Dr. Garcia, I have a serious problem. Twelve years ago, in Florida, I had liposuction of the abdomen and the Dr removed quite a lot of fat and the result was lumpy. I wasn`t an overweight person at the time (5`5 and 130 lbs) but I had a vertical C-section scar from having had 4 children and I didn`t like the crease my skin formed on each side of it. (I couldn`t afford abdominoplasty). I now live in Europe and my medical plan here paid for the abdominoplasty I had always wanted so I had it done in October of 2008. By March I had developed 3 seromas with pseudobursas around them and the surgeon did a second procedure to remove them. It was his conjecture that maybe my previous lipo had been too aggressive and there was scarring which may have caused the seromas. Now it is January, 10 months post my second abdominoplasty procedure and I have another jelly-like mass inside of me which they think is another pseudobursa. I don`t understand this, as I had the drains left in me, post surgery, for 1 week and I wore the garment for 12 weeks after my procedure. My doctor even did an ultrasound 3 months post surgery to make sure there was no fluid there and there was just a little bit near the scar. Now I think I have to have another surgery and I`m really scared. What do you think about this? Please advise me as I don`t know what to do! I am scheduled for an ultrasound in a week but I`m telling you I know what this feels like and there is something bulging out on my abdomen and it feels like a hard bubble that tunnels down me like a tube. My doctor looked concerned. Thank you for reading this. Please respond. Sarah
Answer: well, seromas can happen, even without prior liposuction,I will say that liposuction does cause some scarring, whether it was an aggressive liposuction or not. If you do have another fluid collection with a pseudobursa, it will not go away on its own. The most definitive method is to have it removed, including the entire bursal sac, to avoid recurrance, if the bursa capsule is left, it will reform. In some cases when they are small, injecting the bursa after suctioning the fluid out is possible at the tiem of the ultrasound. The injection of the sclerosing material is meant to scar it down, but is not as definitive as an excision of the bursal sac. All the best. JG 1.8.10
Hi, can the following be performed at one time: breast lift w/implant replacement, mini-abdominoplasty & rhinoplasty. How many days of bed rest is required? How long until full physical activity can be resumed? Regards
Answer: it could, that is alot of surgery, I would only even remotely consider it in a totally healthy person, I think your downtime would be at least 2-3 weeks, and no bed rest, up and walking the same day to avoid blood clots,not back to full activity for likely 6 weeks. JG 2.3.09
Dr. Garcia, I had an abdominoplasty about 3 1/2 years ago. Some time ago, I began noticing a foul smell coming from my navel. The surgery left me with no feeling, still, in the area around my navel, and the navel itself is so tightly sewn that i can barely get a q-tip in there to try to clean myself, nothing happens when i do. what do you suggest??? Thank you.. SM
Answer: might be worth trying to revise the belly button and opening it a little more so it can be cleaned better and avoid the foul smell which is likely the skin oils getting trapped. JG 12.7.08
Hi, Dr. Garcia. Great site! I`m a 43 year old guy. In the early 1990s I lost 180 pounds through diet and exercise, and I maintained the weight loss, with lots of loose skin to show for it. In 2006, I finally had the money to do something about the loose skin, and I had an abdominoplasty, gynecomastia, and a facelift. Unfortunately, the facelift left me with bad hypertrophic (or possibly keloid) scars behind both ears and in front of one. On April 29 (just last month), I had sinus surgery. My ENT also does reconstructive facial plastic surgery and offered to fix my keloids. He removed the keloids, did a revision facelift and treated the incisions with steroids in surgery. He also injected more steroids post op just to be safe. The incisions look great. However, a couple of stitches behind my ear poked through. He said the sutures are permanent and that we would keep an eye on them and trim them as needed. But can more keloiding result from this problem? Will the stitches subside? Am I more susceptible to infection with this problem? Thanks
Answer: the keloids can happen from the suture causing irritation but trimming them should suffice, and it might be wise to have some more steroid injections into the scars until all has dissolved. There is a slight increase in infection risk with exposed suture material. JG 5.22.08
I hear some docs are doing lipo under local (IM). I`m interested in abdominal lipo as I`m not a candidate for abdominoplasty (hx open choles.). I`m looking for a reduction in mass not perfection as I continue fitness regimen. 1. What are your thoughts on lipo under local? 2. Which approach has greater chance of PE? 3. How soon after procedure can one fly? (I`m slated to go to UK mid-July). Thanks.
Answer: I think liposuction under local anesthesia not uncommonly ends up in an inablity to remove all of the desired fat due to feeling pain. I only do it for very small areas. The risk of pulmonaruy embolism is due to the inactivity after the liposuction, not essentially during the procedure, so both have that risk if you do not get up and move around afterwards. Typically I allow the patients to fly after 7-10 days, but they need to get up and walk down the aisle every hour or so to avoid getting a blood clot. JG 5.19.08
Hi Dr Garcia: I`m wondering if you recommend any type of silicone sheets for scar treatment. I have an abdominoplasty scar but more concerned about the scarring from some necrosis to the skin. I used a sheet from my Psurg. for the past two months and I`m not sure I`m seeing much results. I have seen several different types on line but they seem much more expensive. One is called rejuveness. Do you recommend these at all?
Answer: I do not use them as I have found they offer little advantage unless firm constant pressure is applied at the same time and that is really hard to do on most surgical wounds not on the arms or legs. JG 4.17.08
I wrote you a few times--you have a great service for us!! I had multiple revisions on my L breast over an 18 month period due to failure of the implant to drop. It is now very soft, looks very natural. In fact, it is slightly different in shape than the R (more projected, slightly narrower base etc.) I also had a rev. abd done 2 years ago that resulted in a wide scar which sits lower than I wanted, ultimately pulling down my breast creases, creating a flattening look of the underside of my breasts. I have a decision to make: my PS wants to do a capsulotomy on the R breast because he agrees it is stage 2 cc, tight and different shape than the L. He also wants to redefine the L breast crease, since it has been `pulled down` over the last year. THe R breast crease seems to be more intact because I guess the slight CC has keep it from dropping loose into the crease? (the L breast has a natural, slope shape and the R breast looks like a tighter, round breast). Finally, he wants to do a full rev. abd scar revision to give me a prettier, thinner scar. He feels confident that he can do all of it in one surgery. I am scared of doing so much at one time. I feel that if he does the capsulotomy on the R breast, we need to see how it looks after compared to the L and then after a few months, see if hte L breast crease needs to be done only, or if the R breast crease will also need done; together with a rev. abd. scar revision. He wants to use my rev. abd scar as an entry point for the R capsulotomy, leaving the nipple incision alone. I know he can do all of this in 1 surgery, but I have been through 6 procedures in 18 months and I need to make sure that it is a success. I am desperate for two breasts that finally `match` in shape and feel. I don`t want the rev. abd scar revision to pull down on a freshly corrected R breast. Any advice knowing that I need the following: R breast capsulotomy, redefinition of L breast crease (possibly R in future) and complete Rev. abd scar revision? Sorry so long!!
Answer: I think it is safe to do it all at one time but if there is not enough loose skin to revise the reverse abdominoplasty scar, the scar will eventually end up looking the same. JG 4.9.08
I am 48 and have had two previous abdominal surgeries for colon cancer. I have a vertical incision since 2001, and a horizontal incision from a liver resection in 2002. Although I developed a large hernia in the midline incision, I have been colon cancer free. In October 2007, I had a bilateral mastectomy (for DCIS) and immediate reconstruction (DIEP); the plastic surgeon repaired the hernia with a large piece of mesh and finished the abdomen off with an abdominoplasty. I had some seroma formation and some incisional healing problems. One month after the procedure (after several seroma aspirations), I developed an abscess. The abscess drained through the already open part of the incision, but had trouble healing. The surgeon opened up the area and allowed it to heal from the inside out; it took at least 8 weeks to completely close. Since then, the incision above my pubic area looks like a roller coaster; also, I develop a considerable amount of swelling (bloating) after eating anything, or even standing for most of the day. The swelling seems to be a bit less if I wear compression underwear. I bulge in a tire-like fashion above the incision, and also feel a bulge right over my pubic bone. I am concerned these are hernias forming along the horizontal incision. I think it is too far out from the initial surgery to just be post-op healing. I am certainly hesitant to have more surgery but am convinced this problem needs to be fixed, as the swelling really gets uncomfortable. Do you have any ideas or suggestions? Would wearing a compression garment help at this point? (none was recommended after surgery). Thanks
Answer: sounds like recurrent hernias in the incision from the previous surgeries, I think attempt at repair will be a high risk issue too. JG 3.24.08
I wrote you earlier about my reversed abdominoplasty concern about whether I should have a Rev. abd. redo or mini TT redo etc. I saw my ps yesterday and he strongly feels that the best situation is for him to `revise ` the rev. abd scar and leave it alone. He feels that trying to tighten the skin even more, or trying to anchor it up into the fascia using permanent sutures may only create more problems (thick scars, further scar migration etc). I am at peace with this decision. Could you give me your best recommendations for how to `best` heal a revised scar in the rev. abd position? Please keep in mind that the first time he did NOT have me wear any garment or binder or support after. He felt it was not needed. Since then my `scar` has lowered 1-2 inches. In terms of binders/compression/silicone sheeting, cream etc. I really want to know how to make this as pretty a scar as possible. Thanks a bunch!
Answer: I am not a believer in silicone sheets and I do not think the binder will do much besides reduce swelling. For the scar about all I can suggest is Mederma or Scarguard after the sutures are out. Best of luck. JG 3.6.08
Dr. Garcia--- Your information came up during my struggle to find information concerning `reverse abdominoplasty`.....I will give you a quick medical history. I am a physician in Concord, NC. I consider myself to be healthy and in shape (5 ft. 6 and 120 lbs, very active and good dietary/exercise habilts) I had a breast augmentation and mini-abdominoplasty (same surgery) in May 2006 with a board-certified plastic surgeon in Charlotte that I respect and trust. He called it a `mini` abdominoplasty (not a full tummy tuck)because he left a small scar--although he still managed to tighten all of my muscles and remove a lot of skin. Unfortunately after the mini-abdominoplasty both the surgeon and I agreed that there was a lot of skin above the umbilicus that still remained. He suggested a `reverse abdominoplasty`. It seemed like a simple solution to remove the extra skin and we could position the scar within my breast crease. I agreed that this would be a good option for me since the main problem was extra skin above the umbilicus only. I had the reverse abdominoplasty in Jan 2007. Initially, the scar was hidden right within my breast crease (he did a great job shaping the scar to match the natural crease of my breasts). It was a thin, small scar that looked hopeful. I even refrained from all exercise for 3-4 months to allow the tissue/fascia and scar heal. However, within about 4-6 months after the surgery, I noticed that I noticed that the scar began to `drop` to a lower position. Today, it now sits at least 1-2 inches lower than it was originally. I can no longer wear a bikini top because the scar is in full view. This has been emotional for me because I used to `live` in my bathing suit in summer. The scar also widened in thickness quite a lot (3-4 cm) in the lateral portions and the central portion of the scar is fairly raised and rough looking. I discussed this with my surgeon. He graciously offered a `redo` this upcoming April 2008. His plan is to use `permanent sutures` this time (the first time he used the dissolvable kind)suturing the fascia/tissue to the rib cage underneath. He is hoping that this will `hold` the new scar in place high up into the breast crease. What are your thoughts? I don` think I have enough skin left to have a complete TT redo. Plus, I now have this upper reverse abd. scar that needs to be revised anyway. It sounds like you are familiar with this procedure and I would like your professional opinion. What would your best suggestions be for this situation in terms of the surgery? The care for the scars/sutures afterwards in terms of activity/brace/binders/scar treatments? I am really concerned about this procedure because I had no idea initially that there was a risk that this scar could drop so much and be visible. I really don`t want to have to go through this procedure/healing process again just to see the scar `drop` one more time. It has been an emotional journey. My goal is to have the scar `raised` back up to within the crease and stay there permanently. DR -------------------------------------------------------------------------------- Looking for last minute shopping deals? Find them fast with Yahoo! Search. DeleteReplyForwardMove... Previous | Next | Back to Messages Save Message Text | Full Headers
Answer: well, I think permanentt sutures will help some but will likely not totally avoid the recurrance of the problem I am afraid. The sutures might hold but they can tear through the tissues and then essentially there is nothing to support the tissues together and hold then to the ribs. The reality is that the tissue will be pulled downward and in time the scar will migrate, especially when pulled tightly. In your case, since it is a redo, the skin is likely already tight and further tension will likely cause more downward pull and also a greater chance of thicker scars. The longer you wait and allow the skin to get looser the better. It is a well known issue with reverse tummy tucks and I do perform them on a limited number of patients, especially ones after massive weight loss where the scars are less of a concern. Those scars from the reverse tummy tuck are almost impossible to hide in any kind of bathing suit short of a tube top. Wish I had more to offer. JG 2.28.08