Is there any way to fix scar from laparotomy? (photos)

Question

Its from a laparotomy left to heal with 2nd intention. That surgery was in April. The scar is sunken in and really sunken and tight at the bottom end. When I its sort of flat but when I get up its sunken.

Daniel Barrett, MD · Answer

Dear ferni,
it is hard to tell for sure without an examination. Based on your photos, it looks like you would benefit from scar revision. If you are considering surgery, I would suggest you consult a board-certified plastic surgeon. Only after a thorough examination, you will get more information and recommendations.
Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Raffy Karamanoukian, MD, FACS · Answer

Plastic surgery scars require attention after surgery so that they remain cosmetically-appealing and barely noticeable. In our office, we use a protocol for scars that minimizes their activity in the 6-8 weeks after surgery. If you have late plastic surgery scars, you may also require laser and RF therapy to help reduce the longterm effects of the scarring. Keloids, hypertrophic scars, widened scars, red scars, and hyperpigmented scars all require scar modulation with topical creams followed by lasers and RF therapy. Topical skincare should be directed to a specific need, whether for pigmentation or hypertrophy and our office can guide you through the process to obtain the correct Plato’s Scar cream or Melarase cream for hypertrophy and discoloration. In terms of lasers, we would employ the vbeam laser for redness, Venus Viva RF, PRP microneedling, chemical peels, and Morpheus 8, fractional erbium, or fractional co2. All of these have their individual benefits. Most of all, we recommend you visit a solid plastic surgeon who understands surgical scar revision, laser therapy, and RF therapy for scars. 
 
Best, 
Dr. Karamanoukian
Realself100 Surgeon

Shawna R. Kleban, MD · Answer

Scar maturation takes at least 1 full year. However, scar revision (cutting the scar out and closing it back up), steroid/5FU injections, microneedling, and lasers can all be used to improve the appearance of a mature scar. Tethered, depressed, wide scars often require a scar revision.

David M. Kowalczyk, MD, MBA, FACS · Answer

Hi there! The photos help to describe what you're referring to. Minimally invasive options would be Morpheus8 to help soften the scar in addition to IPL for coloration. If these don't work, then a excisional scar revision would be an option. This would focus on improving the scar - especially the inversion. It would be important to make sure your surgeon clears you to perform procedures in that area as there may be critical structures close underneath. Hope this helps you!

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