What Determines Severity of the Tummy Tuck Scar?

In the various before and after Tummy Tuck photos, the scar seen on Tummy Tuck patients vary from severe to hardly noticeable. What determines the severity of the scar? Is it the skill of the surgeon, the healing ability of the body or the amount of excess skin that was removed?

Doctor Answers 17

What determines the final appearance of a tummy tuck scar

The appearance of a tummy tuck scar depends on multiple factors. Your skin tone, ethnicity, nutritional status and your genetics is responisible for the majority of how your scar will look. The surgeon's technique and the tension under which the skin is closed also contributes to the final scar's appearance.  Tummy tuck scars can take up to one year to fully lighten and soften, so patients should expect the scar to look red or maroon in color for the first several months. I recommend patients to use a silicone based gel or tape to their incisions to help improve the cosmetic appearance.

Best wishes,

Dr.Bruno


Beverly Hills Plastic Surgeon
4.9 out of 5 stars 377 reviews

Tummy tuck scar quality is multifactorial

The quality of a tummy tuck scar depends largely on how the tummy tuck wound was closed. There area a variety of modern wound closure techniques that greatly enhance scar quality over the long term. These include the use of barbed suture (Quill) and absorbable dermal staples (Insorb). The other factor that effects scar quality is wound tension. Increased tension created thicker and wider scars. Modern tummy tuck techniques emphasize limiting wound tension. The last issue is scar position - a low lying pelvic scar is hidden and partially fixed in place by the immobility of pelvis soft tissue adhesion zones. Your own innate wound healing biology also greatly effects TT scar quality.

Scott C. Sattler, MD, FACS
Seattle Plastic Surgeon
4.8 out of 5 stars 65 reviews

What determines how my tummy tuck scar will look?

There are many factors that determine the final look of your tummy tuck or surgical scar. Most board certified plastic surgeons practice tension free closure. Other factors include your type of skin, the amount of skin elasticity, and genetics. It is important to have a good  postoperative scar protocol including multivitamins, supplements, topical treatments, and massaging. Close follow up of your scars is important, as sometimes laser resurfacing or other laser treatments are necessary to improve bad scarring. 

Frank Agullo, MD
El Paso Plastic Surgeon
4.9 out of 5 stars 140 reviews

Scarring post-tummy tuck surgery

There are a number of factors that may affect the healing and appearance of a tummy tuck scar. Patient’s are required to refrain from smoking to prevent any wound healing issues. There are multiple factors that could affect your scarring, including your ethnic background, the quality of your skin and genetics. I try my very best to ensure the best and safest result possible intra-operatively to make the incision line as low as possible, hidden underneath the undergarment. The use of deep "tension relieving" sutures may lead to an improved quality scar. There are many silicone products available to aid in the healing process.

Tom J. Pousti, MD, FACS
San Diego Plastic Surgeon
5.0 out of 5 stars 1,486 reviews

Tummy Tuck Scars

There are several factors that are important in determining the appearance of scars.  We, as surgeons, have some control over several of them and very little control over others.  Proper skin tensioning, proper scar location and orientation, and maintenance of adequate blood supply to the skin edges are controllable.  choice of type of closure and suture material is somewhat important but wounds can be successfully closed with a variety of methods that are really immaterial when it comes to the final scar result.  Post-operative wound care is important and avoidance of infection will have positive effects.  There are a number of products on the market that purport to improve scarring but scientific evidence is minimal for most of them.  Simple pressure on a new scar is the easiest, cheapest, and most effective approach.  This can be accomplished in several ways but the easiest is to apply medical tape over a scar which will help keep it flat and pale during the early healing phase.  By far the most important factor in healing and scar quality is genetics, however.  We have very little control, if any, over this factor

Jeffrey E. Kyllo, MD
Seattle Plastic Surgeon
5.0 out of 5 stars 12 reviews

Multiple factors

Assuming that you are seeing a qualified plastic surgeon who will pay attention to detail and perform a multi-layer closure, there are several "non-doctor" factors to consider with the quality of the scar.  First, the quality of your skin to begin with and the amount of elasticity therein.  Second, the degree of tension under which the closure is performed.  Third, post operative scar management can make a difference.  Ask your doctor about taping, scar creams, and silicone gel sheeting, which can all lessen the appearance of the scar.  Lastly is skin type.  The darker the skin type the more noticeable the scar has the potential to be.  Good luck and always look for a board certified plastic surgeon.  

Farzad R. Nahai, MD
Atlanta Plastic Surgeon
5.0 out of 5 stars 4 reviews

How to get better tummy tuck scars

A beautiful tummy tuck scar is low enough to be concealed, pale, and narrow. All scars take time to mature and fade, so one of the most important things to keep in mind when looking at pictures of scars is how long after the procedure the picture was taken. Scars may be obvious early on, but almost invisible after a year. The best results also depend on limiting the tension on the edges when they are sewn together, and I believe the best way to do this is by using Progressive Tension Sutures, which I have been doing for almost 15 years now. This technique distributes the tension away from the wound edges, which is important because regardless of the way the edges are sewn together, tension contributes to more agressive scarring.

Richard Baxter, MD
Seattle Plastic Surgeon
4.9 out of 5 stars 52 reviews

Minimizing the scar in a tummy tuck

What determines the severity of the tummy tuck scar?

In the past, there were only two types of tummy tucks we offered their patients.  Now there are more than 6 that we routinely perform.  All have different scars.

For patients with minimal skin looseness, shorter scar techniques are possible.  It is possible to tighten the entire fascia through a short incision.  There are several types of short incision tummy tucks.

For patients with looseness above the belly button, some form of full tummy tuck is usually recommended.  Now, lower incision tummy tucks are possible in many patients, rather than just the conventional full tummy tuck.  Many patients prefer a small vertical incision with a much lower horizontal incision to a higher horizontal incision with no vertical incision.

The skill and experience of the plastic surgeon play a big role in the ultimate appearance of the scar.  Scars closed excessively tightly tend to spread and be unsightly.  Too much horizontal gathering can predispose to dog ears and a gathered appearance.  Hasty closures are seldom as aesthetic as careful closures.  Poor or hasty preoperative measurements can result in a very asymmetric appearance.

The patient also has a responsibility in the process.  They should follow postoperative instructions and definitely avoid smoking or being around smokers.  Often, there are creams and laser treatments that can improve scarring as well. 

Patients who have very fit pregnancies and limit their weight gain have much less damage than ladies who gain large amounts of weight during their pregnancies.  Therefore, fit moms often qualify for short incision techniques.

Patients who have young elastic skin generally get better results than patients with stretch marks.  Stretch marks indicate that the skin has ripped internally.  The fabric is not the same quality as patients who limit their weight gai and have very healthy pregnancies.

The good news for patients is that in an area many of thought was stagnant a few years ago, there have been huge developments in the available techniques, and patients are recipients of the improvements!

 

Brent Moelleken, MD
Beverly Hills Plastic Surgeon
4.9 out of 5 stars 177 reviews

Scars have many root causes!

1- Genetics - some people are born to have a better scar.

2-Skin tension - more tension equals widen scars

3- Good technique - a technique (like the High lateral tension abdomenoplasty) pulls the tissue and tightens the skin through a deper layer called scarpa's fascia - this pulling from below takes the tension of the skin and scars heal better.

Robert M. Freund, MD
New York Plastic Surgeon
4.8 out of 5 stars 33 reviews

Factors influencing the appearance of tummy tuck scars

The appearance/outcome for tummy tuck scars is dependent on a multitude of factors including patient genetics, ethnicity, skin quality, skin tension, nutrition, physiological age, body mass index (relative obesity), smoking, surgical technique, incision design, compliance postoperatively, postoperative scar care, smoking, underlying medical conditions and activity level (whew!). For photos that are shown online, the greater the time period after surgery, usually the better the scars will appear.

Steven Turkeltaub, MD
Scottsdale Plastic Surgeon
4.9 out of 5 stars 30 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.