Why does the incision line area feel hard? I’m 10 months post-op

Question

Why my full tummy tuck incision line area feel hard? My both sides of incision line feel normal and have nerve sensation w thin line. But my mid incision line is dark color but feel hard on the area, not much sensation are back yet. I’m 10 months post op

J. Timothy Katzen, MD, FACS · Answer

Hello, and thank you for your question regarding why your incision line feels hard 10 months after a tummy tuck.  Thank you for your history in your picture.  What you were describing is completely normal.  Asymmetry of your incision line in terms of texture, feel, and color is normal.  The middle one-third of the tummy tuck incision has more tension and probably less venous blood flow.  That means it’s difficult for the flap to get rid of arterial blood.  That can lead to a buildup of deoxygenated blood in the tissue.  That means the scar will be dark purple.  Alternatively, the discoloration of the scar could be your natural healing.  Also, the midsection of your tummy tuck is the area of most tension, therefore, perhaps a thicker and redder scar.  The hard area you feel underneath the incision is scar tissue.  This is completely normal.  It can take up to two years for a tummy tuck or lower body lift scar to heal.  To decrease the scar tissue, consider a deep tissue massage.  This helps to break up the underlying scar.  In addition, use a vibration massage device, such as a Thera gun.  Massage devices can also help break up the tummy tuck scar underneath the incision.  Please consult with your plastic surgeon regarding breaking up the tummty tuck scar.  It is completely normal to lose sensation in your lower mid-abdomen after a tummy tuck.  This is typically above the incision and below the belly button.  The area of numbness can be as big as your hand with fingers included or as small as a 50-cent piece.  However, almost all patients experience some loss of sensation in the lower abdomen after an abdominoplasty.  Your plastic surgeon should have discussed this with you before your abdominoplasty procedure.  I hope this helps answer the question regarding why your incision line feels hard 10 months after a tummy tuck.  Good luck.  If you have any more questions regarding tummy tucks, abdominoplasties, or abdominal liposuction, contact an experienced plastic surgeon.  Since the tummy tuck surgery is a big procedure, please seek an experienced, board-certified plastic surgeon with significant experience in performing tummy tucks.  Do your research.   If you cannot find an experienced tummy tuck plastic surgeon in your neighborhood, consider traveling out of state.  Sincerely, Dr. Katzen, MD, MBA, FACS, FICS. (Plastic Surgeon, President of the American Society of Bariatric Surgeons, certified by the American Board of Plastic Surgery, Fellow of the International Society of Aesthetic Plastic Surgery, American College of Surgery, and International College of Surgery and member of the American Society of Plastic Surgery, American Academy of Cosmetic Surgery, RealSelf Hall of Fame, and RealSelf Doctor Advisory Board for Medical Review and Consumer Panel.)

Leila Kasrai, MD, FRCSC · Answer

It is not unusual for a single scar to heal at different rates in different areas. Allow up to a year or so for the scar to mature. Continue caring for it as advised by your surgeon.

Jeffrey M. Darrow, MD · Answer

When incisions heal, the skin produces slightly more collagen and more blood vessels than needed for the healing, so scars are frequently slightly firmer, slightly raised and more red than the surrounding tissue.  If the skin has been pulled strongly to suture it together, the scar tends to be more red, raised and firm due to the increased tension in the skin.  Your skin out to the sides is under the least amount of tension and your scar quality is excellent. The skin directly underneath your belly button and slightly to either side is under the most tension and that’s where your scar is most firm.  This is also true for the nerve supply. The areas of the abdomen out to the sides tend to have relatively normal sensation after a tummy tuck. The area underneath your belly button, in the shape of a cone, tends to have decrease sensation which may last up to a year and a half or may be permanent.   You may wish to try some silicone sheeting applied to your scar of your abdomen to see if that helps to settle the scar and help it mature faster. As time goes by you will likely see the scar fade in color and become softer.

Ronald J. Edelson, MD · Answer

It is very common to feel lumps along the incision after tummy tuck. It is scar tissue which usually improves. If you want the lumps are easy to remove

Carmina Cardenas, MD · Answer

All what you feel is completely normal, I have performed thousands of TT and also has myself a Body lift 12 years ago, so I know first hand what is it that you feel. 
The hard areas that feels like a small rope underneath the scar is the line of the internal scar tissue our body creates to heal. It is completely different among people. It is also normal to have a hypersensitive scar. You must deeply massage the scar to make it softer and less sensitive. At least 2-3 times a day every day for at least 4-6 months. 
All what you feel is normal. The numb feeling on the lower abdomen will remain as is. 
Hugs. 
Be encouraged!!
Dr. Cardenas

Camille Cash, MD · Answer

Having firmness along your incision is normal.  It is also normal for parts of the incision to feel less firm than others.  This should improve slowly over time as healing continues.  Massaging the area with Vitamin E oil or using other scar therapies may help.

Mats Hagstrom, MD (license on probation) · Answer

When doing a full tummy tuck, we remove the most amount of skin around the midline of the abdomen.
As we remove skin towards the sides, the amount of skin removed is less and less until it finally comes to a point where the scar ends.
For that reason The middle part of the scar has the greatest amount of tension.
This means sometimes an additional line of deep sutures may be used in that area.
I suggest you talk to your provider and ask him or her about your concerns.
Based on your picture, the scar looks quite different in a very defined area.
It may be a reflection of how the repair was done in the areas holding the greatest amount of tension.
It’s very common that patients to permanently loose sensation above the scar around the mid abdomen. 
This area may never get sensation back.
 Sensation can continue to improve for several years after surgery. 
Again, I suggest you talk to your provider about your concerns.
Best,
Mats Hagstrom MD

Why does the incision line area feel hard? I’m 10 months post-op

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