My Tummy Tuck Scar is Very Dark, is This Normal?

Abdominoplasty scars can be quite complex, ranging from the simple hypertrophic scar to a multiplane inflamed keloid. Pigmentation, discoloration, chronic inflammation, scar visibility can all occur in the short term. We begin each treatment with combination therapy using Yellow broadband BBL, Vbeam, fractional erbium, intralesional IIT, and scar modulation. Start with a combination of Plato's Scar Serum massaged twice daily after one week of epithelialization followed by Luminase/Exfolase. Scar consultation and revision may be recommended.

Best,
Dr. Karamanoukian
Realself100 Surgeon

Hello! Thank you for your question! After any surgical procedure, you should be careful with incisions as well as avoidance of direct UVA and UVB rays in order to lessen the chance for hyperpigmentation of the skin and scars, which can take several months to resolve, if it ever does. Sunblock is recommended regardless. The ability of the affected area to heal has been slowed and you should try to avoid additional swelling to the area. The area will likely be numb for several weeks to months and will be difficult to feel when sunburn is coming on. Typical recommendations include wearing a hat and/or sunblock to the affected area for at least 6-12 weeks following the procedure. It takes up to one year for scars to fully mature. You should also avoid trauma to the area for several months to protect the refinements made during the procedure. Also, avoidance of pools/lakes/jacuzzis/etc for 4-6 weeks is usually recommended to allow adequate healing and protection from stagnant water, that could potentially harbor bacteria. Lifting/exercise restrictions are common for at least 6 weeks. If after this time, consideration for steroid, laser, or scar revision is reasonable. Certainly discuss the postoperative instructions with your surgeon, as thoughts differ among surgeons. Hope that this helps! Best wishes!

Darkness in post-operative scars is normal during the healing process. Scars go through several stages of healing which can take up to a year or more before completion.  Depending on how old the scar is, it could be normal or it could be an early sign of a scar problem. In our practice we always recommend post-operative scar care including massage, strict sun avoidance and consideration of adjuncts such as silicone sheeting or even steroid injection (although this is not often necessary with most cases). Overall scars tend to get better with time. Any doubts should be brought to the attention of your doctor.

 

Thank you for your post. In tummy tuck and other lift/tightening surgeries, tension is the enemy. The scar is healing gradually over 12 weeks or so, and until it is strong, it is the weakest link. As there is a great deal of tension in tummy tucks, body lifts, breast lifts, etc., the scar is at high risk of 'stretching' or widening. Silicone sheeting, although having the ability to make a scar flat, does nothing to prevent stretching of the scar. Creams or steroids or lasers also do not have the ability to prevent stretching of the scar. Those are used if scar is thick or dark, but not to reduce the wideness of the scar, which is the main problem. Massage also does not help keep the scar thin, and can actually worsen the scar in the first 12 weeks because you are actually adding tension to the scar. Massage is for softening a hard or thick scar, but if used early, will hasten the scar widening. Only tension reduction has the ability to keep the scar as thin as possible. You may notice in a lot of tummy tuck scars that the center portion of the scar is the widest with the sides toward the hips being the thinnest. This is because the maximum tension is at the center, and least amount on the sides. Embrace removes a lot of the tension by putting more tension on the skin on either side of the incision and drawing the incision together. It is expensive though at about $100 per week for 12 weeks. When patients do not want to spend the money for embrace, I tape the incision trying to remove as much tension as possible for 12 weeks and recommend no stretching back and to sit most of the time, keeping tension off the scar.Best wishes,Pablo Prichard, MD

Scars heal depending on wound healing genetic and tension on the incision.  As a result some scars may be hyper pigmented or dark.  The inflammatory process associated with wound healing and surgery can also lead to post-inflammatory hyper pigmentation.  It is important to avoid sun exposure to the scars until the scars have faded in color and are no longer red or pink.  Otherwise, they may become dark as well, and stay that way.  There are a variety of scar products with a bleaching or lightening agent you can try.  

Thank you for the question.

Depending on the patient's skin type/ ethnicity etc., hyperpigmentation of scars can be very “normal”. If you have concerns about the nature of your scarring,  you will be best served to address them with your plastic surgeon who is in the best position to advise you.

Best wishes.

Thank you for your question. A dark scar, called Hyper pigmentation, is common in surgical scars in darker skinned patients.

Early pigmentation can be treated with topical Cortisone and Hydroquinone, a skin bleach.

However, dark Tummy Tuck Scars older than 6 weeks usually require more aggressive treatment. I use IPL-Intense Pulsed Light which works very well. Lasers can also be used