AboutAlan M. Engler, MD, FACS Expertise Dr. Engler has answered over 2300 plastic surgery questions for Allexperts. His expertise is in cosmetic plastic surgery including breast surgery (breast enlargement with implants, breast reduction, breast lifts), liposuction, eyelid surgery, tummy tucks, facelifts etc.
Dr. Engler has been listed as one New York`s Top Doctors, and as "One of the World's Most Famous Aesthetic Surgeons" (Aesthetic Surgery, TASCHEN Books, Angelika Taschen, Editor). He is the author of 4 books, including "BodySculpture" (a best-selling plastic surgery book on breast surgery, liposuction and tummy tucks), "EyeScapes" (Plastic Surgery of the Eyelids), "Restylane," and "The Slim Book of Liposuction."
Dr. Engler has two US Patents for surgical instruments that he's designed, and has appeared on numerous television shows, including The Tyra Banks Show, The Ricki Lake Show (four times), and the Dr. Keith Ablow Show. Videos of his appearances are available on YouTube (SEARCH FOR "DR. ENGLER"). His website is www.bodysculpture.com.
Experience Dr. Alan Engler is a board-certified plastic surgeon in New York and the author of BodySculpture - Plastic Surgery of the Body for Men and Women (ISBN 0966382749) one of the top-selling plastic surgery books on amazon.com, barnesandnoble.com, etc.
Organizations belong to ASAPS (American Society for Aesthetic Plastic Surgery); ASPS (American Society of Plastic Surgeons); ACS (American College of Surgeons); Clinical Assistant Professor of Plastic Surgery at the Albert Einstein College of Medicine in New York
Question hi, I am 25 yrs old and I have had one c-section. My scar is almost perfect, you can barely see it. My problem is in the way that it indents. I am very thin and I don't have any extra skin or stretchmarks, I would not be a candidate for a tommytuck or even a mini-tuck. I had a consult with a surgeon and he said that this happens because when my O.B. sewed me back up they only fixed the muscle and the skin and did not repair the fat pad inbetween so the fat separated on either side. He said that we could reopen the scar and repair the fat pad and which would leave me with a nice flat stomach under the scar? My question is does this make sense and have you ever heard of this kind of procedure before?
Answer Hi Val,
There's more about tummy tucks, etc., at www.bodysculpture.com.
This does make sense and I have heard of it. That's the good news. The bad news is that it can be more difficult to accomplish this than it is to describe it.
More specifically, it makes good sense to remove the existing scar, lift up the surrounding tissue and approximate it (realign it) in a way that is presumably more precise than the way it was created (ie, during a C-section, when the appearance of the final scar was a relatively low level concern). That, in fact, may be enough to make the scar look better.
But the problem of the indentation is also caused, in general, by the pulling in of the scar by the joined scar of the muscle. Just fixing that is not always enough and it is, in fact, preferable to put something in between those layers - such as fat - to prevent a recurrence.
However, you may not have enough fat to move around in that region, and transplanting fat from another part of your body, while completely appropriate in general, has a tendency to last unpredictably - some areas better than others.
In sum, though, it is probably worth an attempt to make that scar look better. Removing it, lifting up the surrounding tissue, reapproximating it, sewing it very carefully - are all things that can improve its appearance. And if anything else can be done, such as adding some fat, that would be an added bonus.
