Hi, mgeorges. Hopefully your scar has improved and is now satisfactory? While your question was asked some time ago, I would like to add to the responses, perhaps to help other patients with the same question and concern:Three months out from surgery can be a very funky time as far as scars go. Providing a well-executed repair of your icision by your surgeon, with good support, the incision line is expected to be clean, thin, and flat. (There may be some minor skin puckers, due to correction gathering or areas of stretch marks, that will resolve.). As the incision heals, the scar begins to form and will go through different stages for months and even years. The scar will begin turning pink, and in many may begin to develop a darker, brighter, more purplish or purplish-brown color. Initially the scar will be thin and flat. From this stage, many changes may occur, some predictable and others not as predictable. The scar may begin to widen; thicken; become more raised and lumpy; become more thin, stretched, and jagged; itch; become painful; become more intensely colored; become darker, more purplish or brown; etc., or a combination. Many factors influence the course of one's scar and the final outcome, again some of these factors are predictable and some not so predictable. Some of these factors may be controlled to a certain degree and some cannot. Genetics and a person skin type is a major factor, and cannot be controlled. The location of the scar also is a major factor -- scars on the eyelids, for example, are largely favorable while scars on the upper chest, deltoid area and jaw carry a much higher risk of developing thickening. The orientation of the scar is also critical -- scars following the natural skin lines will fair better than scars in an opposite or in a different direction than the skin lines. For example, the lower, horizontal scar of a tummy tuck will generally due better than a verticle, up and down abdominal scar. Scars will likely do more poorly if the tissues were closed under tension, the circulation of the tissue is suboptimal, the tissues were not well-aligned or not well-supported, there is subsequent skin edge separation or poor healing, infection develops, scabbing present, the tissues become dessicated (dried out), etc. The type of suture used, the number of layers placed, and the care in aligning and supporting the tissues by your surgeon will also influence the scar quality. And finally, the care of the scar by the patient will also have some influence -- keeping the incision clean and slightly moist/protected during the healing period, avoid stress and pull to the suture line, avoiding trauma and compression to the suture line, and providing support and a protective layer (taping, silicone, other scars gels, ?oils, massage, etc.) during the scar phase. Abnormal scarring, such as keloid formation, or over-reactive scar formation (hypertrophy) may require intervention -- and the earlier, the better. It is difficult to evaluate scars from a photo, unless it is significantly abnormal, as the colors are often distorted (especially the red and blues that are typical color elements of a scar -- pink, purple, brown), valuable information of a 3D structure is lost in 2D, and the lights and shadows may obscure or artificial enhance the appearance. I would encourage a patient to discuss the appearance of the scar with his/her surgeon, particularily if there has been a change. At three months, one may be able to positively impact and significantly improbpve the appearance of the scar. I have patients apply a petroleum-based ointment (Vicks) during tne healing phase to provide an optimum moisture environment for the incision; early showering with a chlorihexidine soap to keep the incision clean and free from scabbing; followed by a taping program (the type of tape depending on the scar appearance and progress), once the incision has healed, for many months. Additionally, when possible, I recommend compression and massage of the scar. Each surgeon has his/her scar regimine, and I would always defer to the patient's surgeon.
