Should I Continue Cortisone Shots Or Get a Belly Button Revision

Our office specializes in belly button scar revision after tummy tucks.  I would recommend an aggressive course of scar management with laser, IIT, and topical therapy (Plato's Medicinals Scar Serum) to improve your scar.

I also recommend waiting for another two treatments of steroid injection. Your scars are quite raised and wide and to revise them now would be difficult. If they can shrink, then a revision with simultaneous steroid injection might be the best option.

 

Regards,

Daniel Medalie, MD

I would take a different view from my colleagues who have answered this question to date.  I would recommend a scar revision.

Why?

In most cases of TT where the belly button contracts it's due to tension on the scar line - unless you have a documented history of keloid.  If your lower scar is ok you are not a keloid patient by nature.

This tension is often unavoidable.  In my practice, if I am trying to achieve a good TT result, the belly button is often under some tension, and hypertrophic scars are not uncommon.

However - after a few months, the tension is gone, and the hypertrophic scar can be excised just under local anaesthesia as an office procedure walk in walk out, in my practice for no cost.  It's very simple.

The aim is to have a neat scar sitting just "inside" the belly button at the end, which allows you to wear a bikini or gym gear without being conscious of a visible scar. I am always revising these scars in my office in order to achieve that aim - if the primary surgery doesn't do it.

When I revise a belly button scar, I get the patient to wear a little silicon rubber "ball" or rolled up tape for a month or two in the belly button.  Its easy just to hold that in with some tape.

The problem of the cortisone injections is that the scar hypertrophy can be managed - the scar will soften and fade - but the belly button still won't look very good as the scar itself is broad.

The fact that this has occurred is not your doctor's fault - all TT surgeons see this - but it can be simply managed.  I tell all my TT patients that an umbilical revision as an office procedure is common, as we are aiming for a result which allows the belly button to be exposed with comfort.

 

Hope this helps, good luck.

Based on the picture and the history that you describe, I would suggest the shots as you are having done and wait 3 months to see how your skin responds.  At that time, you may need a revision surgery.

 

Good luck.

I think with examination of the scar  we can tell if it will still respond to steriod. you stll can be benifit from the steroid injections in a shorter period between sessions likeevery 6 weeks . when the scar is already soften most likely it will be wide a scar revion can  be done at that time.for there i wil go if ther eis any signs of hypertophy again will do the massage and silicon sheat so early .

Adding one more opinion to the consensus, it would be prudent to use the steroid approach and hope that the hypertrophic scar formation softens. A scar revision may ultimately be needed, however, though I feel that you still will obtain better results with this approach first.

Your photo shows a significant hypertrophic (over healed) reactive scar after your tummy tuck. We suggest sticking with the steroid program, Kenalog at eight weeks intervals for three sessions before revision. Your doctor is right in that revision can cause more problems with such angry scar present.

Best of luck,

peterejohnsonmd

I would try additional steroid injections, a total of 3 each 1 month apart. I would also consider trying a non-ablative laser treatment on the scar to try to help the scar. ultimately you may need a revision. hopefully your lower scar healed nicer than the umbilical scar.

Steroid injections can thin the scar too much and cause widening.  Dr. Richard Fitzpatrick, a well known dermatologist advised me to use a combination of 90% 5-FU plus 10% Kenalog 10 mg which I like much better.  You could try another 2 injections, but at this point I don't think you are going to get an adequate response as the scar is pretty far along in its maturation process.  I would revise the scar and inject a little of the combination at the time of surgery.  The new scar should be watched closely and if any hypertrophy begins to show do several more injections to keep the over abundance of scar formation at bay.  Good luck

The midline of the abdomen often has thicker scars than either side. I would wait 6-8 weeks after the steroid injection, and then repeat another time if necessary trying to get the skin to soften. after the scars soften they will still be a little wide and that's the time to do a revision AND add a little more steroid to the scar at the time of the surgery to help prevent recurrence. But for now, the best thing youj can do is be patient.