1 year post-op tummy tuck - treatment for dark/red vertical TT scar? (Photo)

Question

I had a TT one year ago. Love my results except for my dark/red vertical scar where my old BB was. All my other scars healed nice and light. Only this one looks like this. What can I do for this? I already did over 6 months of silicone therapy and so that's not the answer I don't think. Do I need scar revision or some sort of laser? Thank you!

Anna Chacon, MD, FAAD · Answer

I can understand why this particular scar bothers you, especially since the rest of your tummy tuck scars healed so nicely. The fact that you have already used silicone therapy for more than six months is helpful to know. Silicone can be useful during scar healing, but it is certainly not the only treatment option.

At one year after surgery, the scar is mature enough that it is reasonable to consider treatments specifically directed at its color and texture. A scar can remain red because of persistent small blood vessels, while darker discoloration can result from post-inflammatory pigmentation. These are treated somewhat differently.

If the primary problem is redness, a vascular laser such as a pulsed-dye laser (PDL) is often considered. PDL specifically targets the blood vessels responsible for persistent redness and can make a surgical scar considerably less noticeable. Treatment is commonly performed as a series rather than expecting one treatment to completely remove the redness.

If the scar is brown or darker rather than predominantly red, the approach may be different. Depending on your skin type and the exact cause of the pigmentation, options can include topical pigment treatments, certain laser or light-based treatments, or other resurfacing approaches. These need to be selected carefully because some treatments can actually worsen pigmentation in susceptible skin.

I would not automatically jump to scar revision surgery simply because the scar is dark or red. Surgical revision is most useful when the scar is problematic in its shape, width, thickness, depression, or texture and is unlikely to improve adequately with less invasive treatment. Even after revision, you are creating a new scar, so there is no guarantee that it will heal lighter than the original one.

If the scar is raised, firm, itchy, or thicker than the surrounding skin, that changes the conversation. Raised hypertrophic scars can sometimes respond to injections such as corticosteroids or 5-FU, sometimes combined with laser treatment.

So, based on what you described, I would think about this in terms of what is causing the color change rather than assuming you need the scar cut out. If it is primarily red, a vascular laser may be much more appropriate than another round of silicone or immediate surgical revision. If it is primarily pigment, the treatment would be different.

One important point is that scars can continue to refine for a considerable period, but at a year, persistent discoloration that bothers you is reasonable to treat rather than simply continuing to wait.

Chet Mays, MD · Answer

Thank you for your inquiry! Scar creams can be used on scars to minimize appearance as well as the silicone scar sheets. Lasers such as Microneedling can also be performed to minimize appearance as well. We would love to see you in person or virtually to discuss treatment options or schedule a consult with a licensed aesthetician.

Raffy Karamanoukian, MD, FACS · Answer

Our office has many different treatments for scars depending on the depth of atrophy or hypertrophy. Scars require a combination approach using our HI DEF protocol which uses a combination of lasers, topical scar modulation, and RF treatments to pixelate scars, improve contour, reduce hyperpigmentation, and improve the visibility of the scars so that they are no longer visible in ambient light. Everyone has a unique pattern of scarring and we employ our HIDEF technique to improve texture, color, contour, and topography. We often use a combination of treatments that begin with a careful examination to examine the micro texturing of the acne scars. Atrophic scars and indented  scars can benefit from injectable fillers such as Radiesse, Sculptra, and Restylane with or without subcision to remove tethered scars and atrophic depression. Hyper-redness in scars can be improved with V beam laser, Excel V, BBL, IPL, and Venus RF to improve  the redness and reduce the visibility of deep scars. Fractional Thulium laser and clear & brilliant can also reduce the inflammation and redness of the scar when combined with topical therapy. Fractional lasers such as Fraxel, erbium, and CO2 laser can be combined with radio frequency and also fractional RF to improve textual issues and microtopography. Subcision and TCA cross are also used for deep ice pick scars and narrow valley scars in order to improve the micro texture.  Above all, our combination approach with our clinical nurses and board-certified plastic surgeons can improve the quality of your skin by using at home Melarase creams combined with PRP treatments in our office to improve your skin quality and tone. I recommend getting a formal evaluation with an experienced team of experts in order to reduce your scarring.
 
Finally, hyperpigmentation of scars can be improved with at-home Melarase AM, Melarase PM, and Melapads to help reduce active PIH and melanin deposition.

Best, 
Dr. Karamanoukian
Realself100 Surgeon

Jeff Rapaport, MD · Answer

Treating a red  tummy tuck scar with a vascular laser or IPL (Intense Pulsed Light) can be effective in reducing the appearance of redness and promoting scar fading. Vascular lasers, such as pulsed dye lasers, target the blood vessels responsible for the redness in scars, while IPL works by delivering broad-spectrum light to target pigment and blood vessels.
Both options can help improve the appearance of the scar by reducing redness and promoting collagen remodeling. However, the choice between the two depends on various factors such as the specific characteristics of the scar, skin type, and individual response to treatment. Find a scar expert. 
Jeff Rapaport MD FAAD 
Realself Hall of Fame
Castle Connolly Top Doctor

1 year post-op tummy tuck - treatment for dark/red vertical TT scar? (Photo)

Answers (4)

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