How can scars be reduced when getting a tummy tuck?

Question

The few ops ive had, most of the dissolvable stiches never dissolve so it takes longer for these areas to heal and somtimes get infection. The scars in those areas remain like keliod, unaffected scars normal. How and would a lock and glue tummy tuck be better for me scar wise

J. Timothy Katzen, MD, FACS · Answer

Thank you for your question. There are numerous strategies for reducing scarring after a tummy tuck. One significant factor is your surgeon's technique during the procedure. Ideally, the tummy tuck should result in a tension-free closure, which can be achieved using a combination of permanent and absorbable sutures.

Permanent sutures are typically used for the abdominal plication, whereas absorbable sutures can dissolve over different periods, ranging from a few days to several months. If you have concerns about absorbable sutures not dissolving completely, I'd recommend asking your surgeon to use dissolvable sutures up to the skin level.

When closing the skin, a permanent suture can be placed for approximately 4-6 weeks. Additionally, I would suggest sealing the skin with glue. This approach is highly effective for patients whose dissolvable sutures don't fully dissolve. Thank you again for your question about reducing scarring from a tummy tuck.

Sincerely,
Dr. Katzen

Ozge Ergun, MD · Answer

Your surgeon will provide specific instructions on how to care for your incisions after the surgery. Following these instructions can help minimize the appearance of scars and promote healing. Keep the incision area clean and dry. Avoid getting the incision area wet until it has completely healed. This will help prevent infection and reduce scarring. Use scar-reducing creams and gels. Ask your surgeon for recommendations. Avoid sun exposure. It is important to note that scarring is a natural part of the healing process and cannot be completely avoided. However, following these tips can help minimize the appearance of scars and promote healing after a tummy tuck surgery.

Raffy Karamanoukian, MD, FACS · Answer

Abdominoplasty scars can be quite complex, ranging from the simple hypertrophic scar to a multiplane inflamed keloid. Pigmentation, discoloration, chronic inflammation, scar visibility can all occur in the short term. We begin each treatment with combination therapy using Yellow broadband BBL, Vbeam, fractional erbium, intralesional IIT, and scar modulation. Start with a combination of Plato's Scar Serum massaged twice daily after one week of epithelialization followed by Luminase/Exfolase. Scar consultation and revision may be recommended.

Best,
Dr. Karamanoukian
Realself100 Surgeon6

Best, 
Dr. Karamanoukian
Realself100 Surgeon6

Brandon Richland, MD · Answer

There are multiple factors that impact how a scar heals. These include your personal ability to heal based on genetic factors, your compliance with postoperative instructions on caring for your incision sites, and avoiding direct sun exposure for the first year. Should you be more predisposed to developing a keloid scar, steroid injections every 4-6 weeks once the incision heals may help in reducing the redness and elevated appearance of such a scar. Additionally, if a scar is hypertrophic IPL or laser treatments can help reduce redness and hyperpigmentation by targeting the melanocytes and HgB in RBCs within vascular lesions that are contributing to the pigmented appearance. 
As for having improved outcomes with regard to your tummytuck's scar, I would recommend a virtual or in person consultation with a tummytuck specialist.
Respectfully, Brandon Richland, MD

Daniel Barrett, MD · Answer

Dear rachw,
scar prevention begins in the OR during the surgery when I meticulously close wounds in multiple layers in order to reduce tension and reduce scars width. I tape my incisions during the early postoperative period to reduce micromotions of the tissues so the incision can heal earlier. I also use compression garments and later Biocorneum gel.
Daniel Barrett, MDCertified, American Board of Plastic SurgeryMember, American Society of Plastic SurgeryMember, American Society of Aesthetic Plastic Surgery

Ahmad H. Ahmadi, MD · Answer

There are many factors that cause ‘ugly’ scars after surgery, such as tension, choice of sutures, infection, surgeon’s skill, and genetics.  Glues and locks do not necessarily result in better-quality scars.  When it comes to any cosmetic surgery, the length of the scar depends on the amount of skin laxity.  Minimizing the scar causes less than optima results and the need for revision surgery.

Connie Hiers, MD, FACS · Answer

The dissolving sutures are not what causes keloids, but glue and tapes often leave nicer scars than those stitched externally.  Scar products after surgery can be very helpful.

Camille Cash, MD · Answer

Each surgeon has her/his own techniques to minimize scarring.  During a tummy tuck typically there are layers of suturing that are done.  You can consider scar treatments such as Embrace Scar Therapy or Brijjit to minimize the appearance of scars.  Other options include silicone sheeting and topical creams.

Mats Hagstrom, MD (license on probation) · Answer

First of all, it takes 12 to 18 months before scars are mature and until you’ve given scars 18 months, you don’t know what the final loud, it’s going to look like.
Anything that increases inflammation during the healing process will cause the body to form excess of scar tissue. The body has in the sense to balancing forces during healing. One is activated by inflammation and includes deformation of scar tissue. The other forest reduces scar tissue information and begins remodeling or maturation of scar tissue, creating a thin, smaller softer scar. Individuals who are prone to hypertrophic, scars, or keloid type scars have an imbalance between those two factors. If possible, the best way is to minimize inflammation. Infections are definitely going to add inflammation and will cause more scar tissue to form. The same is true if people rub his scars, or if scars are chronically irritated by rubbing against clothing. If only certain parts of your scar have undesirable outcomes, then you could consider doing a Square Revision of those areas ones you are 18 months out after finally healing. If there’s a breakdown in the incision at any point in the 18 months start once the wound is healed. The easiest way to reduce hypertrophic scars is with the use of silicone tape, which can be affective, but requires months and months of use.
Silicone tape is more effective an individual’s performance excessive scar tissue than those who heal normally.
Talk to your plastic surgeon about ways to manage the scar.
In the end, people feel differently and individuals who are prone to having hypertrophic scars should consider this as part of the process of deciding if the procedure is justified or not. Are usually take a scar history or inventory anytime I do surgery on any patient. I do this by asking them to show me all Scars or areas of injury they’ve had on their body in the past. This gives me a pretty good idea in my ability to predict what a tummy tuck scar is most likely going to look like. 
For individuals who have a history of hypertrophic scar information this could be the deciding factor of not having the procedure.
Spitting sutures or having sutures become contaminated, sometimes varies from person to person but it’s also to some degree dependent on the technique used by the surgeon.
Anti-inflammatory steroid injections may be a solution for people with very severe hypertrophic scars, but this has a tendency to make the scars wide. Anti-inflammatory steroid injections should generally be avoided, unless absolutely necessary when done it should be done with very dilute solutions in a very conservative manner with long intervals between injections.
Best,
Mats Hagstrom, MD

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