Concerned About Puffy Stretch Marks Near my Incision - Will They Eventually Flatten?

At three weeks post-op, your results look quite good, and your scar will continue to flatten and soften and diminish in redness over 6-12 months. During this time it is critical that you avoid any ultraviolet exposure (including tanning beds) to prevent unwanted scar pigmentation, which can be permanent! You can use mist-type spray tans or self-tanning lotions.

Your residual stretch marks have less collagen and elastic fiber content, which is why they "puff up" when swollen. The post-surgical swelling is lymphatic fluid caused by disruption of the lymphatic vessels in and around your surgical incision. These all need to heal and re-establish the normal lymphatic drainage for the stretch marks to reduce in their visibility. More taut skin with higher collagen and elasticity is less prone to the degree of puffy swelling seen in stretch marks, but even totally non-stretch-marked skin will have some degree of post-operative swelling (edema) and firmness. As overall swelling starts to reduce, the non-stretch-marked skin will lose its edema fluid more effectively, which is why the stretch marks actually look more puffy at 19 days as compared to "everything" is swollen at 2 days!

At three weeks after surgery I recommend scar massage with Vitamin E oil, which can help diminish both scar bulk and firmness. If there is any evidence for scar thickening (scar hypertrophy or keloid formation), I recommend scar pads, which are available at many locations or through your plastic surgeon. Be patient and do not worry!

Your result looks excellent.

Stretch marks can appear quite puffy for a few weeks after surgery. They will become flat without any treatment.

There is often a zone of swelling just above the incision, and this can last for many months.

I always draw a picture of this to show my patients before surgery. Even then I often need to remind them that this is to be expected and will gradually settle down over time.

It certainly appears from your photos that you are on your way to a very good outcome.

In the first month post tummy tuck there can be a significant amount of swelling particularly in the lower aspect of the abdominal flap. This may make some of the associated stretch marks look worse during the short term. This should all improve over time and by six months post op you should appreciate the final result.