What Are my Options for Raised Keloid Circumferential Tummy Tuck Scar from 5 Years Ago? (photo)

Following a large weight loss I had a tummy tuck performed 5 years ago. A year later, I had the tummy tuck extended circumferentially and the front portion of the TT scar revised by a different surgeon. I just had a brazilian butt lift procedure and am happy with my results, however, my scar is even more raised up, thick, and noticeable than before, even through some clothing. The scar is very sensitive and hurts to touch. What are my options both surgical and non surgical to flatten the scar?

Doctor Answers 8

There are multiple nonsurgical treatments for hypertrophic scars or Keloids.

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There are multiple nonsurgical treatments for hypertrophic scars or Keloids. It appears you have a keloid scar from an extended abdominoplasty and body lift. The conservative nonsurgical treatment would include compression with a compression garment. I would also use topical silicone cream. There are many scar creams that profess to improve scarring. However, there are very few creams with silicone in them. I believe the best active ingredient for keloid prevention is silicone. Another modality that I would use to minimize scarring would be the application of silicone strips. These should be worn 24 hours a day. If these conservative modalities do not work, other keloid treatments include injection of the keloid with steroid. Another modality can include early laser treatment. Be certain your board-certified plastic surgeon has the correct laser to use for scars. This is because not all lasers treat scars. If these modalities do not work then I would suggest surgical intervention. This would include meticulous scar resection with scar reapproximation. I would inquire with your prior plastic surgeon as to exactly which sutures were used. It is possible that you are allergic to the sutures used and thus, formed hypertrophic scars or keloids to your body lift. For your surgical scar revision, I would suggest using absorbable sutures to minimize the potential for infection and resulting hypertrophic scars or keloids. Good luck with your revision plastic surgery. Sincerely, Dr. Katzen

Los Angeles Plastic Surgeon
5.0 out of 5 stars 254 reviews

Scar Revision for Hypertrophic Buttock/Back Scars

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Given that this is an established scar, it is not likely much will work other than re-excision of the scars over the visible portions around and across the buttocks. Given that this scar revision will not be placed under too much tension, unlike the original procedure, your risk of recurrent hypertrophic scarring (this is not a keloid) should be low.

Treatment of a 5 year old hypertrophic scar

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First you do not have a keloid scar this is a hypertrophic scar.  The difference is that a keloid scar will continue to grow outside of the normal boundaries of the normal scar destroying normal skin.  A hypertrophic scar is a variation of a normal scar and is usually due to excessive tension.  This seems to be cause of the scar in your case.  At this point the best option would be for a scar revision, possibly in segments this would help to relieve some of the tension on the scar.   Taping of the scar for the first 3 weeks helps along with the use of silicone gel sheeting type of material.  

Jeffrey Zwiren, MD
Atlanta Plastic Surgeon
4.5 out of 5 stars 20 reviews

Best Treatment For Raised Painful Surgical Scar Is 1540 Laser

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Thank you for submitting your question and photograph. You state that you recently had your buttock lift component of your circumferential scar, so I am assuming your scar is relatively fresh.

I have found that the 1540 fractional erbium non-ablative laser produced by Palomar is the most effective and only laser treatment I have found which can flatten and reduce inflammation in surgical scars during my 31 years and practice.

See the link below for photographs of scars treated with this laser

Raised Keloid Scar..

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Your best option is to get kenalog injections, there are no good surgical options for this scar revision.

What Are my Options for Raised Keloid Circumferential Tummy Tuck Scar from 5 Years Ago?

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First you do not have a keloid scar! The scar is slightly hypertrophic and spread. A scar revision could alleviate your issues. 

Options for Raised Keloid Circumferential Tummy Tuck Scar

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At five years, the remedies available are less likely to work than if treated earlier. It seems that the TT incision was revised and then recurred with hypertrophic scarring. 

If you haven't tried the over the counter scar creams I would start there. The "gold standard," which is not to say that it works all the time, is kenalog injection, which your surgeon or dermatologist can do, usually with three treatments two weeks or so apart. 

Since it seems that the TT incision has unfavorable scarring after an attempted revision, I would be cautious about trying surgery again. But do discuss the option with your surgeon.

Thanks and best wishes.

Jourdan Gottlieb, MD
Seattle Plastic Surgeon

Raised Scar After Circumferential Lift

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   If the Brazilian buttlift was done within the last few weeks or months, this may account for the increase in scar prominence and sensitivity.  Depending upon the stage in healing, steroid injections may helpThe scar can be excised once healing is complete and combined with steroid injectionsRadiation therapy following scar excision has the highest success rate, but this can be impractical and expensive.

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.