What to do with remaining belly button tissue on tummy tuck scar? (photo)

Question

I’m 18 months post op on a tummy tuck with T incision. The T is what I believe is my old belly button. This tissue is more inflammatory and responds differently to treatments than the surrounding skin and scar. An aesthetician recommended diluted kenalog injections with a conservative approach. Also recommended CO2 laser. I’m wondering if excising the vertical strip of the T incision wouldn’t ultimately be best for healing. appreciate any and all input!

Raffy Karamanoukian, MD, FACS · Answer

Our office has many different treatments for scars depending on the depth of atrophy or hypertrophy. Scars require a combination approach using our HI DEF protocol which uses a combination of lasers, topical scar modulation, and RF treatments to pixelate scars, improve contour, reduce hyperpigmentation, and improve the visibility of the scars so that they are no longer visible in ambient light. Everyone has a unique pattern of scarring and we employ our HIDEF technique to improve texture, color, contour, and topography. We often use a combination of treatments that begin with a careful examination to examine the micro texturing of the acne scars. Atrophic scars and indented  scars can benefit from injectable fillers such as Radiesse, Sculptra, and Restylane with or without subcision to remove tethered scars and atrophic depression. Hyper-redness in scars can be improved with V beam laser, Excel V, BBL, IPL, and Venus RF to improve  the redness and reduce the visibility of deep scars. Fractional Thulium laser and clear & brilliant can also reduce the inflammation and redness of the scar when combined with topical therapy. Fractional lasers such as Fraxel, erbium, and CO2 laser can be combined with radio frequency and also fractional RF to improve textual issues and microtopography. Subcision and TCA cross are also used for deep ice pick scars and narrow valley scars in order to improve the micro texture.  Above all, our combination approach with our clinical nurses and board-certified plastic surgeons can improve the quality of your skin by using at home Melarase creams combined with PRP treatments in our office to improve your skin quality and tone. I recommend getting a formal evaluation with an experienced team of experts in order to reduce your scarring.
 
Finally, hyperpigmentation of scars can be improved with at-home Melarase AM, Melarase PM, and Melapads to help reduce active PIH and melanin deposition.

Best, 
Dr. Karamanoukian
Realself100 Surgeon

Jeff Rapaport, MD · Answer

It's been eighteen months and your scar is still red. This means the scar is remodeling. A combination of a vascular laser or IPL plus something to flatten  the scar is the most conservative and should be effective. 
We have found that a mixture of Kenalog, 5 FU and Cryo surgery  gives superior results.
When's the scar is flat and no longer red, C02 or Fraxel laser can be employed. A complete  reexcision of the "T" may put you back into the same dilemma. A new micro punch excision technique could be helpful If the above is not successful. Find a scar expert.
Jeff Rapaport MD FAAD 
Realself Hall of Fame

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What to do with remaining belly button tissue on tummy tuck scar? (photo)

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