Revision tummy tuck is generally more complex than the initial surgery due to the presence of old incision lines and scar tissue. Oftentimes, the patients also have some type of navel deformity, contour asymmetry, and residual excess skin, says leading Beverly Hills plastic surgeon Dr. Tarick Smiley.
Dr. Smiley has recently posted a series of Snapchat videos to demonstrate revision tummy tuck performed on a male patient.
A few years ago the patient underwent tummy tuck performed by a different surgeon. But instead of achieving a more masculine physique, the surgery left him with unnatural-looking navel (too big and round), visible asymmetry along his flanks, and high-riding and indented scars.
Aside from revision tummy tuck, the patient also asked for a simultaneous breast reduction to make his chest area congruent with the abdomen.
To conceal the high-riding tummy tuck scar beneath the patient’s underwear, Dr. Smiley created a new incision line (hip to hip) that was positioned very low that it settled within the groin and pubic hairline.
Through the new incision placement, he was also able to eliminate the appearance of indented scar by removing the residual loose skin. Furthermore, he removed more skin along the right flank to eliminate the contour irregularity.
Meanwhile, the celebrity plastic surgeon also performed navel repair, particularly with the intent to reduce its size and change its shape. He said that a natural-looking belly button has a more vertically oriented contour, as opposed to having a perfectly circular shape.
During navel repair, he placed the incision inside the belly button’s rim so the scar will remain imperceptible.
Afterwards, all the incisions were closed by multiple rows of stitches to promote the best scar possible. The skin, meanwhile, was not picked up by any suture and instead a surgical tape held its edges together to reduce superficial tension.
“The key to faded and favorable scar is to eliminate most of the tension on the skin,” says Dr. Smiley.
Dr. Smiley also injected Exparel directly into the abdominal muscle; this is a long-acting numbing medication that works for up to four days, thus allowing the patient to avoid or at least limit his use of narcotic pain relief.