What are these red/purple vertical streaks coming off of tummy tuck scar? (photos)

Question

I am 6 weeks post op full tummy tuck. My incision is pretty well healed but I'm noticing these streaks going up and down along the incision. Everywhere there is significant discoloration, I can feel a lump under the skin. I had spitting stitches on my breast and I have the same discoloration where the stitches were/are. So I'm wondering if this is a reaction to the sutures? Why would the discoloration be getting worse? Would silicone help with discoloration?

Vishnu Rumalla, MD · Answer

Thanks for your inquiry and pictures.  Sutures do unfortunately "spit" for every surgeon and the deep sutures can feel like little lumps.  It is early still in your scar process which continues for years!  I suggest you discuss scar management strategies with your plastic surgeon.  Good Luck.

Kirsty Boyd, MD, FRCSC · Answer

Thanks for sharing your photos.  It is very helpful!  These marks are indeed related to the sutures.  Dissolveable sutures tend to create more inflammation in the short term and in areas where there is tension (such as in the abdominoplasty) then the marks are more prominent.  The normal process for scar healing takes about 18 months, so you are very early in the process.  During the first 12 weeks, your body is forming scar.  Scars look their worst at the three month mark, when they are often firm, red, raised, and uncomfortable.  Then, with time they transition to being more pale, more soft, and more flat.  Some people react more than others to the suture material, and given what happened with your breast, this may be you.  I like silicone sheets for scars - I do find it helps to leach out some of the redness and help soften them faster.  They aren't too cumbersome to wear.  Compression can help, although it is difficult in this area.  If you truly form a hypertrophic scar (very raised and red) then sometimes a steroid injection will also help, however this doesn't seem to be the case from your photo.  I would advise that you give this time.  It should start to settle in a few more weeks.  But don't hesitate to talk to your surgeon if you are concerned ... that is what we are here for! Good luck.

Remus Repta, MD · Answer

Great question.  You are right to state that the vertical scarring is associated with the placement of the sutures. Where the sutures are placed is where the incision has most of the tension located.  Because of this the areas of concerns can be related to the suture itself or to the tension that is found in the area secondary to the suture.  I don't think silicone strips will be of much help.  Perhaps Kenalog injection may help to a certain extent.  Time alone may also be of help.  Sometimes with time, the dark areas fade and the vertical streaking are less visible.I hope this helps.All the best,Dr. Remus Repta

Kouros Azar, MD · Answer

I would definitely advise you to have these assessed in person by your surgeon. Since they are red and getting worse, I always think it best to err on the side of caution and rule out infection. Kindly,Kouros Azar

Morad Tavallali, MD, FACS (retired) · Answer

From the photos I see, the streaks are normal healing, in so far as spitting sutures can be considered normal. After a tummy tuck there is significant tension on the wound and more superficial sutures can affect the blood supply and cause redness. Usually they will go away with time. If the areas of redness become painful and start to have seepage,  make sure you are seen to make sure you do not have an infection.

What are these red/purple vertical streaks coming off of tummy tuck scar? (photos)

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