Do I need a revision on my belly button? (photo)

I am 5 months post op and my belly button did not heal good. I have been using the silicione plug like my surgeon told me too with no results. I am so embarrassed to even show my results to anyone. I had my surgeon tell me to wear two silicone plus. At this point I am very disappointed with my results. Any advice on this. Do I need a revision on my belly button. Which I would like so due to the scar. The surgeon stitched on the outside of the navel, which looks horrible. Any suggestions.

Doctor Answers 3

Abnormal scars and bellybuttons, hypertrophic or keloid

The belly button surgery itself looks good, however your scar is hypertrophic. 

Hypertrophic scars usually form at sites of surgical wounds, lacerations, burns, or inflammatory or infectious skin conditions. They are raised, may be red/pink, and typically do not exceed the margins of the original wound. Hypertrophic scars usually show a rapid growth phase of up to six months, followed by possible regression over the following 12 to 18 months. 

Keloids, on the other hand, present as raised dermal lesions that extend beyond the boundaries of the original wound and invade the surrounding healthy skin. They may arise at sites of minor injuries to the skin, such as earlobe piercings, or may develop in the absence of an obvious inciting stimulus. 

Do you have any other scars, and if so, what do they look like? Was this an abdominoplasty? If so, how does your belly scar look?

Certain types of suture "stitch" material can cause extra inflammation--vicryl is notorious. 

Treatment options: 

Intralesional corticosteroids — Intralesional triamcinolone acetonide is the most commonly used treatment for hypertrophic scars and keloids. Corticosteroids soften and flatten the scar. Treatment is usually repeated several times at four to six-week intervals, but the optimal concentration and number of treatments has not been determined. Intralesional corticosteroid injections can be painful. Other adverse effects include changing color of the skin. Intralesional 5-fluorouracil (5-FU) has been used for scars that do not respond to intralesional corticosteroids

Silicone gel sheeting is frequently used for the treatment and prevention of hypertrophic scars and keloids as well.

Cryotherapy is most useful in combination with other treatments for keloids, although up to 50 percent of patients may respond to cryotherapy alone. A 10- to 30-second freeze-thaw cycle is used and can be repeated up to three times per treatment session. Treatment is repeated at intervals of four to six weeks until response occurs. The major side effects are pain and permanent hypopigmentation, the latter of which limits its use in patients with darker skin. 

Excision — Surgical excision of hypertrophic scars and keloids may be indicated if conservative therapies alone are unsuccessful or unlikely to result in significant improvement. Surgical excision of keloids is associated with recurrence. The combination of surgery with adjunctive perioperative therapies can significantly lower the risk of recurrence:

Find a Board Certified Plastic surgeon who can advise you about these treatments, and weigh your options.

Great work overall, and congrats on your surgery. 

Belly button

There seems to be outgrowing of the scar beyond your initial incision which would suggest it is a keloid scar rather than a hypertrophic scar. You might find steroid injections by your doctor can help a little. It is possible to revise the scar under Local anaesthesia but there is a high recurrence rate unless radiotherapy is given which can reduce the recurrence rate. Please discuss this with your surgeon.  

Belly button.

You have a keloid and it will have to be revised at this stage in the game. This can be done under local anesthesia. If you have insurance, postoperative radiation helps prevent reformation.

Recurrence is common in these cases and a skin graft, while more intensive, can correct this problem in recurrent cases.

Good luck.

Joel M. Stewart, Jr., MD
Newnan Plastic Surgeon
5.0 out of 5 stars 10 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.