Scar Revision of 5 Year Old Tummy Tuck Scar Plus Lowering Possible? (photo)

I had a TT 5 years ago now. Could I get my scar lowered and will it look thinner if the surgeon anchors the skin to my body. The surgeon I have seen has said he can do this and says my scar will look much better due to his stitching technique. Is this true? I am afraid to go through this all over agin and end up with the same ugly red scar. Please help by looking at my pictures. Thank you.

Doctor Answers (11)

Scar care after tummy tuck

+2
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


Phoenix Plastic Surgeon
5.0 out of 5 stars 28 reviews

Tummy Tuck Revision to Lower Scar

+2

   Lowering the scar is reasonable, but suturing techniques are fairly standardized and will likely not produce a better scar.  Kenneth Hughes, MD tummy tuck revision Los Angeles, CA

Kenneth B. Hughes, MD
Los Angeles Plastic Surgeon
5.0 out of 5 stars 238 reviews

Scar Revision of 5 Year Old Tummy Tuck Scar

+2

The scar quality might be better, but lowering it in itself will be a big plus in terms of concealing the scar in clothing..  All the best. 

Jourdan Gottlieb, MD
Seattle Plastic Surgeon
4.5 out of 5 stars 34 reviews

You might also like...

Ways to hide and minimize Tummy Tuck Scarring

+2

Yes your scar can be lowered so it is hidden beneath your panty- line and also at the junction of your pubic hair bearing area. Regarding the potential for a red raised scar please note the following advice that I recommend to my patient in these circumstances:

Best Scar Management is important to minimize or completely hide from view, the tell tale signs of surgery – namely, scars. Both you and your surgeon want you to have the most minimal scarring possible from your surgery.  Patients with scars that are enlarged or not healing well after surgery can be from many causes. Unsightly scars are most commonly due to genetics, underlying medical conditions or improper scar/wound care. The last part is very important and patients can make a noticeable difference in their scars’ appearance by following best scar management practices. Here are some simple tips.
Scar Management tips:
1- Minimize tension on the scar – Steri Strips and/or surgical tape are often placed in non-hair bearing areas to minimize tension and keep pressure over the scar.  This minimizes the  stress that  can pull the scar apart (dehiscence) creating a wound and  delaying healing time, and can make the scar wider, or more “ropy”.
2– Keep your incision site/scar clean to prevent infection. Follow your surgeon’s wound care instructions to the letter with out modification. NEVER apply different products then recommended without first discussing them with your surgeon. This is especially important during the first few weeks. If there are any signs of infection contact your surgeon’s office immediately and/or see your doctor or his nurse immediately. Typical signs of infection may include redness outside the immediate incision site, asymmetric swelling, and drainage, of pus, fever, chills, and “feeling sick”.
3. –Protect your scars from the sun - staying out of the sun is the best advice. Minimal exposure to sunlight is prevents hyperpigmentation (permanently turning brown) and other problems that can make the scar more noticeable. Sunscreen, at least 30 SPF and an overlying make camouflage make up additionally protects the scar from the suns harmful rays. This advice is especially important the first year following your surgery.  .
4. – Use specific scar maturation products recommended by your surgeon. Patients seem to have their own opinions on this touting everything from Pure Vit E, Coco butter, to Aloe Vera, etc but most have minimal benefit other than keeping the scar hydrated. Although hydration is important there are better, scientifically studied products with greater efficacy. Most of the scientific articles written about this subject indicate that topical silicone gel or silicone sheets work the best.  There are a lot of products to choose from, but silicone should be one of the key ingredients. Although Mederma, an onion extract derivative active ingredient rather than mainly silicone based may help, primarily silicone based products are better and many also contain other ingredients that may be synergistic (hydrocortisone or other steroid, Vitamin E, Sunscreen,etc). At the present time I prefer BioCorneum  or Kelo-Cote products and if the reader has problems obtaining these they can call my office. Patient compliance is also critical – use often and according to directions or it will not work optimally. NEVER apply products without first discussing them with your surgeon.
5. – Monitor to make sure your scar is progressing optimally. Keep your scheduled follow-up appointments with your surgeon to verify that your scars are maturing as expected.  Occasionally if indicated you may need a topical steroid preparation or even a series of  injections (5-FU and/or Steroids) or laser treatments  to treat or  prevent scar hypertrophy or keloid formation (red raised scars), or other topical medicines to treat post inflammatory hyperpigmentation (brown scars) with prescription creams and possible laser treatments.

Treatment of Keloids and Hypertrophic Scars after Facelift
Best Scar Management Practice – Advice from Dr. Larry Nichter:
In your particular case it sounds like you have a hypertrophic scar rather than a keloid. Either way my advice is similar. At this late point you may well need a scar revision, a minor office procedure to remove your scar and replace it with a new one. Below are what I feel is important to prevent a future bad scar:
Best Scar Management is important to minimize or completely hide from view, the tell tale signs of surgery – namely, scars. Both you and your surgeon want you to have the most minimal scarring possible from your surgery.  Patients with scars that are enlarged or not healing well after surgery can be from many causes. Unsightly scars are most commonly due to genetics, underlying medical conditions or improper scar/wound care. The last part is very important and patients can make a noticeable difference in their scars’ appearance by following best scar management practices. Here are some simple tips.
Scar Management tips:
1- Minimize tension on the scar – Steri Strips and/or surgical tape are often placed in non-hair bearing areas to minimize tension and keep pressure over the scar.  This minimizes the stress that can pull the scar apart (dehiscence) creating a wound and  delaying healing time, and can make the scar wider, or more “ropy”.
2– Keep your incision site/scar clean to prevent infection. Follow your surgeon’s wound care instructions to the letter with out modification. NEVER apply different products then recommended without first discussing them with your surgeon. This is especially important during the first few weeks. If there are any signs of infection contact your surgeon’s office immediately and/or see your doctor or his nurse immediately. Typical signs of infection may include redness outside the immediate incision site, asymmetric swelling, and drainage, of pus, fever, chills, and “feeling sick”.
3. –Protect your scars from the sun - staying out of the sun is the best advice. Minimal exposure to sunlight is prevents hyperpigmentation (permanently turning brown) and other problems that can make the scar more noticeable. Sunscreen, at least 30 SPF and an overlying make camouflage make up additionally protects the scar from the suns harmful rays. This advice is especially important the first year following your surgery.  .
4. – Use specific scar maturation products recommended by your surgeon. Patients seem to have their own opinions on this touting everything from Pure Vit E, Coco butter, to Aloe Vera, etc but most have minimal benefit other than keeping the scar hydrated. Although hydration is important there are better, scientifically studied products with greater efficacy. Most of the scientific articles written about this subject indicate that topical silicone gel or silicone sheets work the best.  There are a lot of products to choose from, but silicone should be one of the key ingredients. Although Mederma, an onion extract derivative active ingredient rather than mainly silicone based may help, primarily silicone based products are better and many also contain other ingredients that may be synergistic (hydrocortisone or other steroid, Vitamin E, Sunscreen,etc). At the present time I prefer BioCorneum  or Kelo-Cote products and if the reader has problems obtaining these they can call my office. Patient compliance is also critical – use often and according to directions or it will not work optimally. NEVER apply products without first discussing them with your surgeon.
5. – Monitor to make sure your scar is progressing optimally. Keep your scheduled follow-up appointments with your surgeon to verify that your scars are maturing as expected.  Occasionally if indicated you may need a topical or injection of a steroid preparation or even a series of  injections (5-FU and/or Steroids) or laser treatments  to treat or  prevent scar hypertrophy or keloid formation (red raised scars), or other topical medicines to treat post inflammatory hyperpigmentation (brown scars) with prescription creams and possible laser treatments.

Larry S. Nichter, MD, MS, FACS
Orange County Plastic Surgeon
5.0 out of 5 stars 50 reviews

Revision?

+1
Hello! Thank you for the question! Given your photos, a full tummy tuck revision with liposuction is reasonable. That should meet your goals. It is common for scars to fully mature for up to a year. In the meantime, there are a few things that may help to ameliorate your incision/scar. The most proven (as well as cheapest) modality is simple scar massage. Applying pressure and massaging the well-healed scar has been shown to improve the appearance as it breaks up the scar tissue, hopefully producing the finest scar as possible. Other things that have been shown to add some benefit, albeit controversial, are silicone sheets, hydration, and topical steroids. These can usually be started at approximately 3-4 weeks postop and when incisions healed. In addition, avoidance of direct sunlight to the incision will significantly help the appearance as they tend to discolor with UV light during the healing process. Scars will never disappear, but attempt is made to make the finest scar in a concealed location. Incisions may be revised to lower or conceal better if enough laxity exists.

If unsightly scars are still present after approximately a year's time, other things that your surgeon may consider are intralesional steroid injections, laser, or just surgical revision of the scar itself.

Hope that this helps! Best wishes!

Lewis Albert Andres, MD
Scottsdale Plastic Surgeon
5.0 out of 5 stars 12 reviews

Scar revision after a tummy tuck

+1

Based on the photos you submitted, your 5 year old tummy tuck can definitely be revised and the scar lowered.  The appearance and the color of your scar will depend upon a combination of your surgeons technique and your body's unique ability to form scar.  Good luck.

Sacha Obaid, MD
Dallas Plastic Surgeon
4.5 out of 5 stars 25 reviews

Repositioning a tummy tuck scar

+1

Thanks for your question.  I think it is important to keep the tummy tuck scar as low as possible so that it is hidden in undewear/bathing suits.  Instead of positioning the scar in a high position, I'm in favor of lowering the scar and creating a small T at the midline where the belly button skin ends up.  Based on the pictures, your scar is a little high.  The scar can be lowered by a revision procedure.  It appears you have enough skin laxity to allow for enough downward movement of the scar but I could only be certain after a physical exam.  The scar quality would likely improve as well because there would be less tension on the the tissue than during your initial procedure.  Good luck and consult with a board-certified plastic surgeon in your area.

Jason E. Leedy, MD
Cleveland Plastic Surgeon
5.0 out of 5 stars 34 reviews

Re-do tummy tuck 5 years later....

+1

can always be done but many factors come into play.  Is your excess below the belly button or not?  If you have a lot of excess on top, you may need to have your belly button released again with a new scar between your belly button and the transverse scar.   If your tummy is 'thick' to pinching, you could potentially benefit from liposuction but your surgeon may not be able to employ what he is thinking if liposuction is done at the same time.  Improvements can be made but you should understand fully just what the recommended procedure will accomplish for you before signing up.

Curtis Wong, MD
Redding Plastic Surgeon
4.5 out of 5 stars 17 reviews

Lower Tummy Tuck Scar with Revisionary Surgery?

+1

Thank you for the question and pictures.

Of course, direct physical examination will be necessary to give you precise advice. However, based on your  good quality pictures,  I think that it is very likely that you will be able to lower the abdominoplasty scar  with revisionary surgery.  Exactly how you will scar however cannot be predicted.

 You may benefit from in-person consultation with board-certified plastic surgeons.  Ask to see lots of examples of their work.

Best wishes.

Tom J. Pousti, MD, FACS
San Diego Plastic Surgeon
5.0 out of 5 stars 793 reviews

Car Revision of 5 Year Old Tummy Tuck Scar Plus Lowering Possible?

+1

Yes it could be possible. But only in person evaluation from a boarded PS in your city allows a definitive response. 

Darryl J. Blinski, MD
Miami Plastic Surgeon
4.5 out of 5 stars 64 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.