Do scars continue to widen after they reach their maximum tensile strength at 9 weeks?

Question

Last year after my lbl my incision opened in the back the scar widened significantly. It continued to widen much long after 9 weeks (beyond 6 months). I recently underwent a revision and fortunately nothing opened. However, should I still exercise some caution even after 12 weeks and beyond? I want to start power lifting (dead lifts and squats) but don't want the scar to widen. Do scars continue to widen after 9 weeks or perhaps mine did last time because of the original dehiscence? Thanks.

Swet Chaudhari, MD · Answer

This is an excellent question. So sorry for the dehiscence you experienced. The healing of a surgical scar is dependent on many factors, including age, nutrition, location, number and type of sutures placed, and most importantly tension. The original dehiscence probably happened because of tension. The revised scar is probably also under some amount of tension, perhaps less. Typically scars that are not under tension will begin to contract as the collagen fibers mature, but if the scar is under tension, then it's a whole other ball game. Tension (or pulling force) across the incision contributes significantly to widening of the scar over time. Hopefully you have minimal tension and enough strong sutures that tension will be insignificant and the scar will strengthen and contract nicely, but there is simply no way to be sure. It's probably best to avoid any tension across that incision for 6 months, but please consult your plastic surgeon for his/her professional recommendations.

J. Timothy Katzen, MD, FACS · Answer

Thank you for your question regarding scar widening after surgery. It's understandable that you're concerned, especially given your previous experience with incision opening and scar widening following your lower body lift (LBL).

Typically, scars reach their maximum tensile strength around 9 to 12 weeks after surgery. However, scar maturation continues for up to a year or more. While most scars will stop widening significantly after this point, there are certain factors that can cause scars to stretch or widen beyond this period. In your case, the original dehiscence (incision opening) likely contributed to the prolonged scar widening you experienced last time.

Even after 12 weeks, it’s still wise to be cautious, especially with activities like power lifting, which place significant strain on the body. Deadlifts and squats engage the core and lower body muscles, which could create tension on your scar tissue. While your incision may have healed well this time, overly strenuous activities too soon could still cause the scar to widen or stretch.

I recommend gradually reintroducing weightlifting into your routine and paying close attention to how your body responds. It’s also a good idea to consult with your surgeon about the timing for returning to heavy lifting and ask if scar treatments, like silicone sheets or scar massage, can further strengthen the scar tissue.

I hope this helps address your concerns and guides you toward a safe return to your workouts.

Sincerely,
Dr. Katzen

Jean Loftus, MD · Answer

Very good question. In fact scars begin to widen out about the two month mark and may continue to widen for several months thereafter. The degree to which your scars will widen has more to do with tension on the scars and the heaviness of the skin and fat that may be exerting tension on the scars. Scar width does not typically have much to do with postoperative exercise or activity.

Do scars continue to widen after they reach their maximum tensile strength at 9 weeks?

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Do scars continue to widen after they reach their maximum tensile strength at 9 weeks?

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