What Can Fix This This Hole in my Incision? I've Tried Many Options, Nothing Is Working. (photo)

Question

A year ago, I had a tummy tuck and didn't like the scar. I decided to do a scar revision, but the incision has since not healed. The surgery was at the end of January!! I have gone back to see my doctor as well as another ( for a second opinion) and had stitches, sutures, staples and glue and nothing is working. I don't know what I am doing wrong. I am not active ( holding off on the gym). I am not drinking or smoking. Any tips to help healing? What would a doc do with skin so weak it rips?

Gerald Minniti, MD, FACS · Answer

Hello Waygook,

	I am sorry you are having this problem.  I can't be certain from your description of what you've been through, but looking at the photo it seems that your doctor has been trying to close an open wound with very heavy sutures under tension.  This is not conducive to either effective healing or an improved scar; it also puts you at risk for further tissue injury and even infection.  At this point, all sutures need to be removed, and any tissue that does not appear healthy needs to be removed.  A regimen of saline soaked dressings needs to commence to keep the wound clean, lower bacteria colonization, and encourage rapid healing. This is not a job for sutures, staples, glue, or any other closure device.  Your body will have to do the job on its own, which might take a few weeks to a month. 

	I would seek out another plastic surgeon, one who is well respected and highly experienced in all types of plastic and reconstructive surgery.

	Best of luck.

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

Robert L. Kraft, MD, FACS · Answer

This suggestive of an underlying infection or process that has not resolved.  If you were not operated on by a board certified plastic surgeon, then I recommend that you see one.  Wound cultures should have been taken.  You may need for the wound to be re-opened and explored for infection.  I would like to know whether you have been on antibiotics and the result of any wound culture.  You may need to see an infectious disease specialist if this does not resolve.  The inability of skin to close is indicative of an underlying process rather than simply weakness of the skin.

John P. Di Saia, MD · Answer

Hello,

	 

	You can't revise a wound that has not yet healed. It needs to heal and mature, then you can consider some kind of revision. If it is not healing you need to see your surgeon to help figure out why.

	 

	Best Regards,

	John Di Saia MD

What Can Fix This This Hole in my Incision? I've Tried Many Options, Nothing Is Working. (photo)

Answers (4)

Answer: Let it heal completedly first.....

Answer: Let it heal completedly first.....

Recommended reading

Everything you need to know about Scar Removal

Our mission is to create a world where every investment in modern beauty is Worth It.

What Can Fix This This Hole in my Incision? I've Tried Many Options, Nothing Is Working. (photo)

Answers (4)

Answer: Let it heal completedly first.....

Answer: Let it heal completedly first.....

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Recommended reading

Everything you need to know about Scar Removal

Our mission is to create a world where every investment in modern beauty is Worth It.