What can I use or do to flatten the tummy tuck incision scar? (Photos)

Question

I had an MMO in January 2023. My tummy tuck incision opened, and the incision scar was raised, along with the area where the drains were removed. I am concerned because the scarring is dark; it's sensitive and not improving. I am using silicon strips and bio-oil, but I have not seen any change. I have returned to the surgeon, who told me to use stips; no additional suggestions, post-op recommendations, or support has been offered. What can I use or do to flatten the scar

Gary M. Horndeski, MD · Answer

I recommend scar revision and this can be done under local anesthesia.  At the same time or later, you can use steroids to help prevent the hypertrophic scars.

Best Wishes,

Gary Horndeski, M.D.

Raffy Karamanoukian, MD, FACS · Answer

Our treatments use combination therapy to improve the epidermis and dermis for most deep scars. The options available for acne scars depend on the character of your scars, in terms of topography and contour. We see atrophic and hypertrophic acne scars, as well as scars that have hypo and hyperpigmentation. We begin each scar evaluation with an assessment of scar quality and subtype. Our main concern is rebuilding collagen and that is why we use a HIDEF protocol that includes combination therapy. Morpheus 8, scar subcision, fibrous release, fractional laser, CO2 laser, Thulium laser, PDL Vbeam laser, and fractional resurfacing can be used in addition to TCA Cross and chemical peels to further improve skin. Patients should start Melarase AM and Melarase PM for active hyperpigmentation. Always begin with a consultation to decide whether early subcision should be started.

Best,
Dr. Karamanoukian
Realself100 Surgeon

Best, 
Dr. Karamanoukian 
Realself100 Surgeon

Anna Chacon, MD, FAAD · Answer

When the body produces an excess amount of collagen it can cause Hypertrophic scarring. The most common type of Hypertrophic scarring is Keloids. These can cause a raised tummy tuck scar that may be a deeper red or darker brown than the rest of your skin. Laser resurfacing treatments like HALO and Profractional can make scars less noticeable by smoothing their texture.

Jeffrey H. Spiegel, MD · Answer

This is called hypertrophic scarring where the scar is overgrown.  Silicone strips can help, but you likely need steroid injections.  I do these things in the office and we would expect that to settle quite readily.

Nelson Lee Novick, MD · Answer

From the photos there appear to be keloid scars and hypertrophic scars. I don't find silicone patches and gels to be particularly effective modalities in general for scars and are very unlikely to be of much value in the cases of keloid and hypertrophic scars. On the other hand, the use of intralesional anti-inflammatory injetions of varying concentrations and amounts of triamcinolone acetonide with or without  the addition of 5-FU can be quite effective in flattening these scars. Hope this helps and best of luck.