Red itchy scars are called hypertrophic scars and are common following abdominoplasty. They are more common when:

1. The skin is pulled too tight
2. Too much skin is removed
3. You are too active and stretch or stress the skin soon after surgery
4. Your belt buckle or tight clothing irritates the wound
5. Some people are prone to develop hypertrophic scars.
   

Ideally a properly done tummy tuck like the bikini tummy tuck will have minimal scars which are well hidden (see below).

Above-Before and After Bikini Tummy Tuck

There are several ways to improve red scars or hypertrophic scars after tummy tuck or abdominoplasty:

1. Apply 1% Cortisone cream to the scar
2. Inject Cortisone into the scar
3. Apply Cordran Tape to the scar
4. IPL (Intense Pulsed Light) treatments to the scar
5. Lux 1540 Laser Treatments to the scar
   

Cortisone cream and Cordran Tape can only be used for limited time periods because Cortisone a steroid cream can cause skin atrophy.

I use the IPL to remove redness and the Lux1540 Laser to soften and reduce the scar.

The IPL and Lux1540 laser treatments are safe, new and very effective. They are my first line for any red scar or raised scar today.

Results on very difficult scars can be excellent. (See below)

For more information on the newest laser treatments read Save Your Face or contact me.

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Thank you,

Dr Seckel

978-369-4499

Boston, Massachusetts

Concord, Massachusetts

The bikini tuck or bikini tummy tuck is a modified abdominoplasty which places the scar in a position which is hidden when you wear a bikini. The results are excellent and you can still wear a bikini when you go to the beach after your tummy tuck.

Above-Before and after Bikini Tuck Abdominoplasty.

The bikini tuck works best when there is small to moderate skin excess of the lower abdomen. The bikini tuck also works well when you have a C-Section scar.

Many people want to have a tummy tuck but don’t want a visible scar. By placing the incision low and following the lines of your bikini, the scar is hidden by most bikinis and today’s brief underwear.

There is no scar on the “belly button” with the bikini tummy tuck.

To learn more about the tummy tuck or abdominoplasty procedure visit drseckel.com or contact me.

Be sure to sign up for my free email newsletter.

Thank you,

Dr Seckel

978-369-4499

Boston, Massachusetts

Concord, Massachusetts

Thank you for your question. Interestingly, women in your age group who have had children and share your concerns are the largest group of patients seeking Breast Augmentation in my Boston Plastic Surgery Practice, and have been for many years. The use of the name “mommy makeover” has brought a great deal of attention to the combination of breast and abdominal or tummy rejuvenation following pregnancy, usually a combination of a tummy tuck or abdominoplasty and a breast lift or dermal mastopexy with or without breast augmentation or breast enlargement. Many women complain of small breasts, sagging breasts and a loose tummy or sagging tummy skin after pregnancy.

Most commonly in my practice a “mommy makeover” consists of a tummy tuck and a combination of the breast lift and breast augmentation. Recent studies have reported that the combination of these procedures is safe if performed properly on a healthy patient.

Above-Before and After Bikini Tummy Tuck

Below-Before and After Breast Lift and Breast Augmentation

My own opinion is that the mommy makeover, that is the combination of a tummy tuck, breast lift and breast augmentation or breast enlargement can be done safely under the following circumstances:

1. The patient is healthy-a Class 1 Anesthesia Risk-that is a person with no significant medical disease such as diabetes, high blood pressure, significant obesity, history of blood clots, and many other potential medical complicating conditions.
2. The board certified plastic surgeon is skilled and experienced at doing multiple procedures
3. The procedure can be accomplished in less than 4 hours ( this is my personal opinion, longer surgeries increase risk )

The mommy makeover requires a healthy patient and an experienced and skilled plastic surgeon that can expeditiously perform the combination of a tummy tuck, breast lift and breast augmentation. Your choice of a surgeon is critical and you need to ask specific questions about the doctor’s experience and the time it will take for the operation.

Not every patient who wants a mommy makeover requires all three operations, that is a breast augmentation, breast lift and tummy tuck. Many women only need a breast augmentation if they have small breasts after pregnancy but not sagging breasts. Other women who have adequate breast tissue but sagging breasts will only require a breast lift or dermal mastopexy. In my practice a mommy makeover which requires only a minor tummy tuck and a breast augmentation can be achieved in less than 2 hours.

If a combination breast augmentation, breast lift, and a major abdominoplasty are required the procedure can take as much as 3 hours.

The decision as to what type of mommy makeover is required depends on your particular anatomy. You can read more about how decisions about breast augmentation, breast lift, and tummy tuck are made by reading my previous blogs on this topic.

The mommy makeover, that is the combination of a tummy tuck and breast lift and or breast augmentation, in my experience, produces excellent results and produces some of my happiest patients. The improvement in the self esteem of my patients has been remarkable. Many patients say “I can’t believe it”, “I love my breasts and my new shape” and other happy comments.

The most important thing for you is to make certain you are healthy and you must find an experienced plastic surgeon who can safely and in a reasonable operative time accomplish a good cosmetic result.

If you would like to see results of plastic surgery visit my clinical website drseckel.com.

If you would like to learn more about how to choose a plastic surgeon read Save Your Face. If you would like more information contact me.

Dr Seckel

978-369-4499

Concord, Massachusetts

Boston, Massachusetts

Your question is one of the most common situations I see in my plastic surgery practice. Most women who have had children notice lax abdominal skin or a sagging tummy and experience laxity of the breasts or sagging breasts and no amount of hard work can completely firm these areas back to the way they were before pregnancy.

The tummy tuck and breast augmentation or breast lift are frequently done together. A minor tummy tuck involves only an incision down low in the abdomen which can be designed to be hidden under today’s brief bikini’s so that the scar is not visible at the beach. A major tummy tuck, called an abdominoplasty, done when there is a great deal of abdominal skin laxity and excess abdominal skin and stretch marks, require an incision around the “belly button” or umbilicus, and thus creates a visible scar. Most women in your age group only need a minor tummy tuck.

Many women who only have a small amount of sagging of the breast, called glandular ptosis, can restore their breast shape and firmness with only a breast augmentation or breast enlargement with a breast implant. The implant can be a saline breast implant or a silicone gel breast implant which has a more natural feel.

For women who have more severe breast sagging, called breast ptosis, a breast lift or dermal mastopexy is required. This decision is made based on your breast anatomy. Generally if the nipple is below the inframammary crease (IMC) the diagnosis of mammary ptosis is made and a breast lift or dermal mastopexy is required.

Most women do not want to have the breast lift, called a dermal mastopexy, done because the dermal mastopexy or breast lift creates visible scars on the breasts. However the breast lift or dermal mastopexy can create a beautiful youthful breast shape and many women choose this procedure and accept the scars which are much less noticeable with time.

The lollipop lift or lollipop breast lift is a procedure designed to minimize the scars associated with the breast lift or dermal mastopexy. The lollipop breast lift involves a circular scar around the areola and a vertical scar running straight down the breast beneath the areola so it looks like a lollipop when viewed from the front.

My recommendation is that you consult 2 surgeons who are certified by the American Board of Plastic Surgery and get their opinions as to the best options for you.

Thank you for your question.

For more information on plastic surgery and non-surgical facial rejuvenation read Save Your Face or contact me.

Dr Seckel

978-369-4499

Concord, Massachusetts

Boston, Massachusetts

No laser, including the Fraxel® laser has yet been shown to effectively remove stretch marks in the skin. While lasers can lighten the color of skin stretch marks, and increase the production of collagen in the dermis to possibly reduce the depth of the stretch mark, the results to my eye are not satisfactory.

Please check my previous in depth discussion of strectch marks in the skin by clicking on this link in the Ask Dr Seckel section. In my experience only an abdominoplasty or tummy tuck effectively removes stretch marks and then only the stretch marks in the skin that is removed.
Unfortunately many advertisements and marketing claims create the impression that stretch marks can be removed when in fact the best a laser, even the Fraxel, can do is to lighten the color and soften the appearance. The stretch mark is still there. Always seek reputable medical advice from a board certified doctor. Reading Chapter 10 in Save Your Face, and paying attention to the 10 “red flags’ will also help you avoid being misled.

Thank you for your question. To learn more visit my Boston Plastic Surgery Practice, contact me or read Save Your Face.

Sincerely,

Dr Seckel

Boston, Massachusetts

Peabody, Massachusetts

Thank you for your question. The short answer is that there are no satisfactory easy, non-surgical solutions for stretch marks in any skin type, African American, Caucasian, Asian, or other.

Stretch marks are caused by disruption and damage to the collagen in the dermis of the skin, the layer just beneath the outer surface of the skin. This disruption of the dermis occurs as a result of severe stretching of the skin and stretch marks result. This profound stretching of the skin most commonly happens during pregnancy when the abdominal skin stretches so much during such a short period of time. Stretch marks can also occur, usually over the hip or thigh area, during the rapid period of body growth during adolescence. I have also seen stretch marks occur in the skin overlying muscles in body builders who have “pumped up�? their muscles over a very short period of time. Stretch marks also occur in people with Cushing’s Syndrome a medical condition which is the result of excessive levels of the adrenal hormone cortisol. This later cause of stretch marks is proof of the damaging effects of cortisol, the stress hormone.

Interestingly when the skin is stretched slowly over a period of time stretch marks do not occur. An example is breast augmentation or breast enlargement which is done frequently and almost never results in stretch marks. The only time I have seen stretch marks occur after breast augmentation or breast enlargement was in a body builder who vigorously lifted weights shortly after her breast augmentation. Another example is soft tissue expansion which we do to stretch the skin and reconstruct a new breast after mastectomy for breast cancer. These patients almost never develop stretch marks even though we stretch the skin considerably but very slowly.

Several Lasers have been advertised to remove stretch marks, but the results are not satisfactory. The laser can lighten the stretch mark color, but the stretch mark is not removed. Strivectin® and other crèmes are advertised for stretch marks but I am not impressed with results.

The only way I have been able to successfully remove stretch marks is to surgically remove them. The problem with this approach is that the surgery also leaves a scar.

The most satisfactory results for removal of stretch marks is the abdominoplasty operation. Typically a woman has loose skin and stretch marks on the abdomen after giving birth to her children. In many of these cases, the loose skin and stretch marks can be removed during the abdominoplasty operation. The tummy or abdomen is tightened and a nice flat tummy can be achieved and most if not all of the stretch marks removed. The scar is hidden underneath the “bikini line�?.

I hope this information is helpful. I am sorry there is no easy solution for stretch marks. I will address your question on Cellulite as a separate question, later. Visit my Boston Plastic Surgery Practice or read Save Your Face. Thank you!

Sincerely,

Dr Seckel

Boston, Massachusetts

Peabody, Masachusetts