Ask Dr. Pane: Tummy Tuck Revision Question From Palm Beach Gardens, Florida

Dr. Pane reviews the case of a patient who is interested in a second tummy tuck to correct loose skin.

The Question

Sometimes the body changes after cosmetic surgery. When this happens, the initial results may need a little extra help, especially if the patient’s primary body objectives or aesthetic focus shifts. An example of this is the subject of Atlantic Coast Aesthetics’ Ask Dr. Pane segment this week. This viewer is from Palm Beach Gardens and has already undergone one tummy tuck. She asks, “Should I have a second tummy tuck for loose skin?” She adds that she underwent a tummy tuck and hernia correction about a year and a half ago. She’s quite happy with her appearance in regular street clothing, but is interested in a further revision including a belly button, or navel, correction so she can feel comfortable wearing a bikini.

The Case

Dr. Pane evaluated the photographs the patient included with her question. He noted moderate to severe stretch marks extending to the upper regions of the abdomen and some looseness of the skin around the lower abdomen.

The Answer

Sometimes, there simply isn’t a great answer, and Dr. Pane was quick to point out that this is one of those times. Because of the overall condition of the patient’s skin, the best she can realistically expect in this case is a tradeoff.

Dr. Pane says if she goes for an “inverted T” abdominoplasty which will remove skin in the horizontal dimension around the back and on the lower abdomen, it may help smooth out the stretch marks somewhat. However, this will leave a scar which will be highly visible in a two-piece bathing suit, something which most patients would prefer to avoid. If, on the other hand, she has the excess skin removed through a basic abdominoplasty procedure which removes skin in the vertical dimension, this will not address the stretch marks to any significant degree. It will leave her more or less where she started with regards to being able to wear a bikini without fear of the stretch marks showing, but will eliminate the excess skin. In this particular case, it is really going to come down to the lesser of two evils. There is a lot to evaluate and consider, and the patient will need to decide whether she would prefer to show a high-visibility scar or a mass of stretch marks.

Although cosmetic surgery has made amazing strides just in the last decade, scar remediation and stretch mark revision remain some of the more difficult issues confronting cosmetic surgeons. There is only so much that can be done to reduce or modify the appearance of scars and stretch marks once they occur, and even with the best possible care, they will still be visible to some degree. This can leave even the most confident cosmetic surgery patient feeling self-conscious about their body and reluctant to wear the daring fashions they would otherwise love to. For this reason, cosmetic surgeons make every effort to conceal surgical scarring in areas where it will not be evident to the casual viewer, such as beneath the breasts where it will be easily concealed with a bra or bikini top, or below the bikini line.

RealSelf Patient Reviews of Thomas A. Pane, MD

It is important to remember that photographs can only tell a surgeon so much about the problem areas under consideration. Lighting, distance, the type of camera and so forth can all make problem areas appear better or worse than they actually are. In addition, it is exceedingly difficult to properly evaluate the elasticity and general quality of the skin and determine any conditions which may impact the skin positively or negatively from photographs. An in-person clinical evaluation is by far the best method to properly analyze the available options and help decide what the best way forward will be for the patient to achieve the results they want.

If you have a question regarding any aspect of cosmetic surgery or the available procedures for your unique needs, everyone at Atlantic Coast Aesthetics including our founder, Dr. Thomas Pane, are ready and willing to discuss your specific interests anytime! Just follow us on Facebook, Twitter and Instagram; call us at (561) 422-4116; or email us at Your question could be the focus of an upcoming Ask Dr. Pane segment, helping us inform and educate others while giving you the straight talk you need to make a sound decision about how to proceed. Remember, at ACA we believe the only bad question is the one you don’t ask!


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