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How Do You Avoid Tension on the Incision During Healing?

In a tummy tuck, the external flesh is repositioned - I'm curious about closing of the incision and how tension/pulling is avoided. Is it usually closed with sutures or staples? Won't gravity (or any physical positions that either arch the spine or stretch the skin upwards) affect the scar healing? Also (similarly), what is the result if too much flesh were to be removed, causing an upright physical posture to pull too much on the sutures/staples? Hypothetically.

Doctor Answers (5)

Avoid staples and follow your surgeon's post-op instructions

Immediately after surgery, the skin will feel tight. For the first 2-3 days, you are encouraged to walk slightly bent forward to avoid pulling on the incision line, and to put pillows under your knees and your head when you’re reclining so you’re bent at the waist. You can also sleep on your side in a slight ‘fetal’ position (ie bent at the waist). You may find it difficult to rise from a lying position and it will be easier to turn on your side, allow your legs to hang over the side and slowly use your arms to raise yourself to a sitting position before rising. Avoid sitting up in a chair for the first week. Avoid straining, lifting, and bending completely over. These are my guidelines but you should follow your surgeon's.

Sutures are preferred over staples, as staples result in scarring that is generally more uneven and visible. 

Toronto Plastic Surgeon
5.0 out of 5 stars 63 reviews

Reducing incision closure tension is important for better scars.

All Plastic Surgeons try to minimize tension on the skin closure with every procedure performed. This has a little bit of influence on the scars final appearance. We all have our preferred approach. I choose to use progressive tension sutures and place most of the tension on the deeper layers rather than the skin. After surgery there is always a period of tissue tension adjustment as your posture gradually straightens. The skin and incision will stretch during this time as well. In most cases, the scar will mature normally and appear like a stretch mark rather than a thin line after a year. Many of us also employ proactive strategies to manage the scar during the most important early months after surgery. Careful planning, skilled surgical technique and proactive scar management strategies have made the appearance of abdominoplasty scars much less problematic. Good luck!

Mathew C. Mosher, MD
Vancouver Plastic Surgeon
4.5 out of 5 stars 12 reviews

Incision tension


With a plastic surgical closure of a wound, care is usually taken to close the would in layers taking tension off of the skin closure.  This will help give you a good scar.  I also will usually place steri strips on the incision which helps remove the most superficial tension as well as put pressure on the scar which can help.

Gary Hall,MD

Gary Hall, MD
Kansas City Plastic Surgeon
4.5 out of 5 stars 25 reviews

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Controlling tension on tummy tuck scar for better healing


Tension on a wound is one of the biggest contributors to poor scar formation, so methods like the progressive tension suture method help by placing the tension away from the wound edges. This uses a series of stitches under the flap that distribute the tension on deeper stronger layers that the skin. It also helps minimize the need for drain tubes. We also use tape on the incision for about 6 weeks which also helps reduce tension.

Richard Baxter, MD
Seattle Plastic Surgeon
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Tummy tuck wound tension


The tension of a proper tummy tuck closer is placed along the superficial fascial layer - this is closed with a heavy, absorbably barbed suture in my practice. The skin itself is on no tension when the wound is closed. This technique has yielded high quality scars.

Scott C. Sattler, MD, FACS
Seattle Plastic Surgeon
4.5 out of 5 stars 37 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.