Age 63, what can be done to remove my vertical hysterectomy scar? (Photo)

Question

Hello, I am 63 years old. I had a total abdominal hysterectomy in the early 1980’s. Over the years I did not think I could ever have this very unattractive scar removed. I have gained confidence to search for this possibility. What can be done to remove it?

Jeffrey H. Spiegel, MD · Answer

The scar is contracted and recessed relative to the soft tissue around it.  To fix this you'd want to have the scar released and redone, and, the soft tissue around it reduced. That can be done with a tummy tuck (best), or possibly even bodytite/liposuction in the office.

Raffy Karamanoukian, MD, FACS · Answer

Plastic surgery scars require attention after surgery so that they remain cosmetically-appealing and barely noticeable. In our office, we use a protocol for scars that minimizes their activity in the 6-8 weeks after surgery. If you have late plastic surgery scars, you may also require laser and RF therapy to help reduce the longterm effects of the scarring. Keloids, hypertrophic scars, widened scars, red scars, and hyperpigmented scars all require scar modulation with topical creams followed by lasers and RF therapy. Topical skincare should be directed to a specific need, whether for pigmentation or hypertrophy and our office can guide you through the process to obtain the correct Plato’s Scar cream or Melarase cream for hypertrophy and discoloration. In terms of lasers, we would employ the vbeam laser for redness, Venus Viva RF, PRP microneedling, chemical peels, and Morpheus 8, fractional erbium, or fractional co2. All of these have their individual benefits. Most of all, we recommend you visit a solid plastic surgeon who understands surgical scar revision, laser therapy, and RF therapy for scars. 
 
Best, 
Dr. Karamanoukian
Realself100 Surgeon

Christopher Pannucci, MD, MS · Answer

Hi Thrifty945257,
The vertical, below belly button scar is within tissue commonly removed during a tummy tuck. Standard tummy tuck, performed in the face up position, does 3 things. First, it removes excess lower abdominal (below the belly button and above the pubic hairline) skin and subcutaneous excess, second it generally performs liposuction to contour the flanks, and third it will allow plication to repair any right to left gap between your 6 pack muscle. Tummy tuck would be one option to remove the scar completely, replacing it for a longer and lower horizontal scar.
The alternate solution would be to excise the scar, and replace it with a new vertical scar in the same position. The difference would be in the closure. The appearance of your scar suggest that Scarpa's fascia, the strong fascial layer with in the subcutaneous tissue, was not closed, allowing the scar to indent quite severely. Alternatively, if you had an infection and the wound healed in secondarily, that would produce this appearance as well. The second option for you would be to have the scar revised in order to create a new, more ideally contoured vertical scar.
Hope this helps.
Best,Christopher Pannucci MDBoard Certified Plastic SurgeonPlastic Surgery NorthwestSpokane, Washington

Camille Cash, MD · Answer

Scar revision may be an option for you.  This involves removing the old scar tissue and creating a new incision with intentions for it to heal more favorably.  I encourage you to begin by visiting with a board certified plastic surgeon near you for a consultation to learn more.

Leo McCafferty, MD · Answer

Thank you for your question, and I believe your lower abdomen could be improved with a combination of liposuction, scar revision and some form of an abdominoplasty.  Please have a very careful evaluation by a board certified plastic surgeon as the resulting scar from the previous intra-abdominal procedure adds a level of complexity to liposuction and/or an abdominoplasty.  I am certain that you can realize some improvement in your area of concern and good luck to you.

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