High scar
The scar lies higher than expected and is visible under underwear or swimwear. Visible scars on the sides and outside of underwear are among the known complaints after a classic abdominoplasty.
CONDITION / TORSO AND ABDOMEN
Unsatisfactory result of abdominoplasty.
An unsatisfactory result of abdominoplasty is when, after tummy tuck surgery, the scar is high, wide, or deformed, there is excess skin or fat remaining, the navel has changed, or fluid accumulates under the skin (seroma). Some of this is corrected with a repeat correction once the tissues have healed.
CONCEPTUAL VISUALIZATION- What it is
- The scar, skin, fat, or belly button after abdominoplasty is not as expected, or there are healing complications.
- How common
- In a series of 278 abdominoplasties, late defects occurred in 25%: "dog ears" at the ends of the scar – 12%, excess fat – 10%, unsatisfactory scar – 8%.
- Seroma
- Accumulation of fluid under the skin. In a meta-analysis of 143 studies (27,834 people) — 10.9%.
- The most dangerous
- Blood clot in the lung vessels: in a cohort of 11,137 patients, 87.2% of such cases occurred after discharge. With symptoms — call 103.
01 / WHAT IS ITWhat is
What is
Unsatisfactory result.
Abdominoplasty, or tummy tuck, is a surgery in which excess skin and fat on the abdomen are removed, and, if necessary, separated muscles are stitched together. According to the NHS, during a full abdominoplasty, a long incision is made across the lower abdomen from hip to hip, above the pubic area, and the navel is moved to a new opening. After the procedure, there is a scar on the lower abdomen and, in a full operation, a scar around the navel.
Some changes after surgery are normal healing. According to the NHS, abdominal numbness can last from several months to years, fluid may temporarily accumulate over the scar, and a red raised scar fades in 12–18 months. Full recovery occurs in about 6 weeks.
Unsatisfactory result — something that does not improve over time: the scar lies high and is not hidden under underwear, it is wide or thick, the ends of the scar have "flaps" of excess skin, the skin above the scar hangs down, the sides or upper abdomen remain full, the navel is deformed. Reviews by French surgeons state that in 30% of cases the result is insufficient and the person requests a repeat procedure.
Healing complications are considered separately — seroma, hematoma, infection, skin necrosis — and a rare but dangerous blood clot in the pulmonary vessels.
This is general information. The doctor will tell you what will suit you after the examination.
02 / SIGNSWhat can
What can
go wrong
Some defects are visible immediately after swelling subsides, some — when the scar matures, after months.
A rough scar
The scar is wide, thick, red, or tight. According to a meta-analysis of 10 studies (1533 patients), 2.4% had a hypertrophic scar.
Hypertrophic scar"Dog ears" and excess skin
At the ends of the scar, skin folds stick out, or the skin above the scar hangs down.
Sides and upper abdomen
The sides or area above the navel remain full, there is no waist curve. Fat remnants are one of the reasons for repeat procedures.
Navel
The navel is deformed, displaced, narrowed, or with a coarse scar. According to a meta-analysis, navel problems occurred in 1.58% of patients.
Seroma and wound
Fluid collects above the scar, the area swells and “sloshes”; or the wound has opened or is not healing.
Difference of seams03 / REASONSWhy it happens
Why it happens
works out.
Part of the causes are related to the surgical technique, part — to the person's health and weight.
Technique of the first operation
According to a review by French surgeons, following technical rules during the first abdominoplasty can reduce defects that later require repeat interventions.
There is a lot of skin or fat left
When the excess is not completely removed, "ears" appear at the ends of the scar, and the sides and upper abdomen remain full.
Smoking
According to a meta-analysis of 82 studies, smoking statistically significantly increased the risk of complications after abdominoplasty, as well as after most cosmetic surgeries.
Weight, age, gender
In a cohort of 25,478 abdominoplasties, the relative risk of serious complications was higher in men (1.8), people aged 55 and over (1.4), and those with a body mass index of 30 and above (1.3).
Several operations at once
In the same cohort, serious complications after a single abdominoplasty occurred in 3.1%, and in combination with liposuction and other body contouring procedures — in 10.4%.
04 / SEEK MEDICAL ADVICE
When to seek medical advice?
A high or thick scar, "ears," excess skin, or a deformed navel noted months later is a planned situation and generally does not require urgent care. Another matter is the first weeks after surgery. In a cohort of 11,137 patients after abdominoplasty or panniculectomy, a pulmonary thrombus occurred on average 10.5 days post-surgery, and 87.2% of these cases occurred after discharge. If any of the signs listed below appear, do not wait for it to pass and do not travel on your own — call 103.
103 immediately if:
- it suddenly became difficult to breathe;
- chest pain or pain in the upper back;
- the heart beats very often;
- a person has fainted, even briefly;
- heavy bleeding from the wound that does not stop;
- confusion, slurred speech;
- very frequent breathing;
- skin or lips bluish, pale, or blotchy;
- very high temperature or severe chills;
- a rash that does not go away when pressed.
Do not delay a visit to the surgeon:
Immediately - to the surgeon who operated, and if it does not work - to the reception department: severe or increasing abdominal pain or pain in the surgical area; the surgical area swells rapidly, becomes tense, and painful. On the same day: to the surgeon who performed the operation, or if this is not possible — to any surgeon, if one leg (usually the calf) is painful and swollen, coughing up blood appears, the skin near the scar or navel darkens, turns blue or black, the wound is red, hot, oozing pus, the stitches have come apart, or the temperature rises to 38°C and above. In the coming days: swelling over the scar that "squishes" under the fingers or increases — possible seroma. Planned: high or thick scar, "dog ears," excess skin or fat, navel — the scar matures in 12–18 months, but you can see a doctor earlier.
05 / DIAGNOSTICSAs defined,
As defined,
what to fix
- Conversation and documents
When, where, and exactly what type of abdominoplasty was done, whether the muscles were stitched, how the healing proceeded; discharge summary and preoperative photos, if available.
- Review
The surgeon examines the abdomen standing and lying down: the level and quality of the scar, "ears," remaining skin and fat, navel, abdominal wall tone.
- Cause of the defect
What exactly is wrong — skin, fat, scar, or navel; this determines which correction to choose.
- Ultrasound if necessary
Helps to find a seroma or other fluid accumulation and assess the abdominal wall.
06 / TREATMENTHow to fix
How to fix
result
Acute complications are treated immediately. Aesthetic correction is planned when the wound has healed, swelling has subsided, and the scar has matured: from a small scar excision under local anesthesia to a repeat operation.
01
First weeks
Healing complications.
- Lung thrombus
- He is treated in the hospital with blood-thinning medications; according to the NHS, if detected and treated early, a full recovery is possible. In a review of 1,596 patients, thrombosis after abdominoplasty occurred in 0.56%.
- Seroma
- The fluid is removed by puncture. In a series of 310 abdominoplasties, seroma occurred in 4.8%, and it was successfully treated by fluid aspiration.
- Wound and skin
- The wound is cleaned, a vacuum dressing is applied if necessary, and once clean, it is re-sutured. Dead skin is removed and the defect is closed.
02
scar
Care from the first weeks, correction after maturation.
- Care and silicone
- According to international guidelines, silicone gel or sheets are the first choice for preventing and treating hypertrophic scars; it is also recommended to reduce tension, tape, moisturize, and protect the scar from the sun.
- Scar excision
- Later, a persistent coarse scar can be excised and sutured again, combining the procedure with other methods.
- High scar
- Incorrect scar placement is one of the reasons for repeat abdominoplasties. What can be done in your particular case will be explained by the doctor during the examination.
03
Skin, fat, and the navel
Repeat correction.
- What is corrected
- In a review by French surgeons, the causes of repeat abdominoplasties were named as residual excess skin, residual fat, incorrect scar placement, and navel defects.
- How common
- In a series of 278 abdominoplasties, repeat surgeries were required in 24%: most often additional liposuction (12%), excision of "ears" (10%), and scar correction (5%).
- Navel
- Navel defects are among the complications for which methods of prevention and treatment have been described; the method of correction is chosen after examination.
04
Repeat abdominoplasty
- Indications
- According to a systematic review of 16 studies (262 patients), repeat abdominoplasty is performed due to complications of the first operation, dissatisfaction with the shape or unevenness, as well as after surgeries performed abroad.
- Risks
- The repeat surgery has its own risks: in the same review, complications after it included infection, seroma, skin necrosis, hematoma, and wound dehiscence. The data are limited and heterogeneous.
07 / AT THE VALIKHNOVSKYI INSTITUTE
How
How
we treat it.
Unsatisfactory results of abdominoplasty at the Dr. Valikhnovskyi Institute of Surgery are treated in the direction of "Treatment of complications of aesthetic surgeries" — including situations where the first operation was performed at another clinic or abroad. Bleeding, hematoma, infection, and necrosis are treated immediately; pulmonary thrombus — in a multidisciplinary hospital; aesthetic correction — after healing and reduction of swelling.
CLINIC SERVICE
Treatment of complications of aesthetic operations
Skin necrosis, dehisced wounds, capsular contracture, liposuction irregularities, and gross scarring.
View service
What we do for this condition
- Excision of scars — A coarse or wide scar is excised and sutured using a different technique; hypertrophic and keloid scars are treated in a combined manner.
- Silicon and fractional laser — scar care from the first weeks; laser or IPL — if the scar becomes noticeable.
- Repeat liposuction and lipofilling — excess fat is removed, depressions are filled with your own fat.
- Abdominoplasty and diastasis repair — in the 'Slim Abdomen' approach: the separated rectus muscles are stitched together, if necessary — along with the removal of excess skin.
- Treatment of seroma and wounds — the wound is cleaned, fluid is removed, a vacuum dressing is applied if necessary; when the wound is clean — it is sutured again.
- Closure of necrosis — dead tissues are removed and the wound is closed with local flaps, a graft, or a microsurgical flap.
- Lymphatic drainage and physiotherapy — in the direction of "Rehabilitation after aesthetic surgeries": reduce swelling and help return to activity.
Rostislav Valikhnovskyi
Plastic surgeon, candidate of medical sciences, founder of Dr. Valikhnovskyi Institute of Surgery.
How treatment works with us
- Photo onlineSend a photo of the abdomen standing, from the front and side, and, if available, the discharge summary from the clinic where the abdominoplasty was performed.
- ConsultationExamination of the scar, skin, navel, and abdominal wall; if necessary — ultrasound.
- PlanWhat to treat now, and what — after scar maturation, and whether multiple stages are needed.
- CorrectionExcision of the scar or "ears," liposuction, treatment of seroma — depending on the defect.
- RecoveryCompression underwear, scar care, reviews; the final appearance of the scar is assessed after months.
08 / QUESTIONS AND ANSWERSCommon
Common
questions
Short answers. What is right for you, the doctor will tell you during the consultation.
Is it possible to correct an abdominoplasty performed in another clinic or abroad?
Yes. The doctor assesses what is now and makes a plan. Take a statement from that clinic and a photo before the operation, if you have them.
Swelling above the scar that "squelches." Is this dangerous?
This may be a seroma — a fluid accumulation under the skin. According to the NHS, temporary fluid accumulation above the scar is common, but see a surgeon in the coming days: the fluid is removed by puncture if necessary.
When can a scar be corrected?
Usually after it matures: according to the NHS, a red raised scar fades within 12–18 months. Care with silicone can start earlier. The exact timing will be given by the doctor during the examination.
What are "ears" and are they removed?
These are folds of excess skin at the ends of the scar. In a series of 278 abdominoplasties, 12% of patients had them, and excision of the "ears" was required in 10%.
Is it possible to have a repeat abdominoplasty?
Yes, but it has its own risks — infection, seroma, skin necrosis. Whether it is needed or a smaller correction is enough, the doctor will say after an examination.
Does smoking affect the result?
Yes. According to a meta-analysis of 82 studies, smoking increased the risk of complications after abdominoplasty. It is worth quitting smoking before the correction.
What signs after abdominoplasty are dangerous?
Sudden shortness of breath, chest pain, rapid heartbeat, fainting — call 103. Severe or increasing abdominal pain or rapid swelling in the surgical area — immediately to the surgeon who operated, and if that is not possible — to the emergency department. A clot can appear at home: in a large cohort — on average 10.5 days after surgery.
Sources
18 sources · systematic reviews, meta-analyses, cohorts, patient series, guidelines, and NHSshowCollapse
- Abdominoplasty: Risk Factors, Complication Rates, and Safety of Combined ProceduresPlastic and Reconstructive Surgery, 2015doi:10.1097/PRS.0000000000001700 ↗
- Managing Complications in Abdominoplasty: A Literature ReviewArchives of Plastic Surgery, 2017doi:10.5999/aps.2017.44.5.457 ↗
- The Global Prevalence of Seroma After Abdominoplasty: A Systematic Review and Meta-AnalysisAesthetic Plastic Surgery, 2021doi:10.1007/s00266-021-02365-6 ↗
- Complications of 278 consecutive abdominoplastiesJournal of Plastic, Reconstructive & Aesthetic Surgery, 2006doi:10.1016/j.bjps.2005.12.060 ↗
- La chirurgie secondaire des dermolipectomies abdominalesAnnales de Chirurgie Plastique Esthétique, 2019doi:10.1016/j.anplas.2019.07.002 ↗
- Revision Abdominoplasty with Truncal Liposculpting: A 10-Year ExperienceAesthetic Plastic Surgery, 2019doi:10.1007/s00266-018-1176-0 ↗
- Outcomes and Indications in Revision Abdominoplasty: A Systematic ReviewAnnals of Plastic Surgery, 2025doi:10.1097/SAP.0000000000004513 ↗
- Stigmata of Stigmata of Abdominoplasty: A Systematic Review and Meta-AnalysisAesthetic Plastic Surgery, 2026doi:10.1007/s00266-026-05962-5 ↗
- Pulmonary Embolism Risk After Cosmetic Abdominoplasty and Functional PanniculectomyAnnals of Plastic Surgery, 2022doi:10.1097/SAP.0000000000003281 ↗
- Venous Thromboembolism and Bleeding Events With Chemoprophylaxis in Abdominoplasty: A Systematic Review and Pooled Analysis of 1596 PatientsAesthetic Surgery Journal, 2021doi:10.1093/asj/sjab090 ↗
- Clinical Evaluation of 310 Abdominoplasties and Measurement of Scar LevelAnnals of Plastic Surgery, 2023doi:10.1097/SAP.0000000000003550 ↗
- A Procedure and Complication-Specific Assessment of Smoking in Aesthetic Surgery: A Systematic Review and Meta-AnalysisPlastic Surgery, 2024doi:10.1177/22925503221085083 ↗
- Updated Scar Management Practical Guidelines: Non-invasive and invasive measuresJournal of Plastic, Reconstructive & Aesthetic Surgery, 2014doi:10.1016/j.bjps.2014.04.011 ↗
- Efficacy of Manual Lymphatic Drainage in Reducing Postoperative Complications After Cosmetic Plastic Surgery: A Systematic ReviewPlastic and Reconstructive Surgery – Global Open, 2026doi:10.1097/GOX.0000000000008139 ↗
- Tummy tuck (abdominoplasty)NHS, 2023nhs.uk/tests-and-treatments/cosmetic-procedures/cosmetic-surgery/tummy-tuck ↗
- Pulmonary embolismNHS, 2026nhs.uk/conditions/pulmonary-embolism ↗
- DVT (deep vein thrombosis)NHS, 2026nhs.uk/conditions/deep-vein-thrombosis-dvt ↗
- SepsisNHS, 2026nhs.uk/conditions/sepsis ↗
The figures on the page are from these sources.
Abdomen after plastic surgery
Not the way you wanted?
Send a photo of your abdomen and discharge summary from the clinic where the abdominoplasty was performed. The doctor will say what can be corrected and when.