Abdominal scar revision/surgery options? (Photo)

Question

I have a abdominal scar that is the result of an exploratory surgery at the age of 3 months. The scar always feels tight and is inhibiting my ability to eat the right amount of nutrients. Anytime I eat I’m in agony from the scar/tissue trying to stretch. Wondering if anything can be done to possibly remove the scar and some of the scar tissue. This scar has also affected my mental health and self esteem. If possible I would like for it to be removed and my belly button fixed as it was displaced.

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

Jason Emer, MD · Answer

It's difficult to determine the best solution for you without the benefit of a formal evaluation. Generally speaking, scars can be improved with a combination of surgery and/or lasers and microneedling with PRP. Below is a more detailed reference list of the treatments available. I recommend getting a formal evaluation with a scarring expert to determine which is best for your specific case. 
Options can include:
1. Vascular lasers (BBL, Yellow laser, V-Beam, Excel V) 
2. Fractional lasers (Fraxel, Erbium, CO2, Halo) 
3. Microneedling/PRP 
4. Silicone-based scar gels with growth factors 
5. Excision/revision surgery 
See an expert to develop a treatment plan that works for you. Best, Dr. Emer​

Nelson Lee Novick, MD · Answer

The therapy of choice--that has a more than five decades long track record for efficacy-- for flattening elevated, keloid scars, such as these appear to be, and "proud flesh" (hypertrophic) scars, remains intralesional injections of anti-inflammatory agents, such as triamcinolone+/- 5-FU. Relatively expensive, faddish, Johnny-come-lately "bells and whistles" devices, like RF and fraxel lasers may be heavily supported by a whole lot of device manufactuer marketing hype, but, to date, still lack the hard science to support their use, and, surgical scar revision, especially in areas subject to muscular tension or motion, run the risk for the development of stretch scars and tram track stitch scars. Make sure to see a board certified cosmetic dermatologist with extensive scar treatment experience, and best of luck.

Daniel Barrett, MD · Answer

Dear adrianique16,
it is hard to tell for sure without an examination. Based on your photos, it looks like you would be a good candidate for 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

Abdominal scar revision/surgery options? (Photo)

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Abdominal scar revision/surgery options? (Photo)

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