What Can I Do About Long-term Tummy Tuck Scar Pain?

Thanks for the question.
It is unusual to need a compression garment after 8 weeks.
Scar pain can be caused from a number of issues including abnormal healing from the scarring (keloid or hypertrophic scars), injury to cutaneous nerves in the area, or other issues.
Treatment at this point can include:
1. steroid injection - this can be particularly helpful in cases of hypertrophic scars or cutaneous nerve injury. Risks include atrophy or hypopigmentation in the injected area.
2. scar revision - this may help the pain and the appearance of the scar (if this is a problem) but it may also not help your pain and you have to deal with healing another surgery. The pulling sensation you describe may be an area of scar tissue or a deep suture that can be released with this method.
Massage may help but you may be more likely to get improvement with the treatments above.
Speak to your plastic surgeon in depth about your concerns.
I hope this helps.

Hello Hollye in Texas. Thank you for your question regarding the long-term pain you are experiencing along your tummy tuck scar. It's understandable that this would be a concern, especially 17 months post-surgery.

Persistent pain, burning, and pulling sensations at the scar site can occur, but they should generally diminish as time passes. However, since you are still experiencing significant discomfort, here are several approaches that may help alleviate your symptoms:

Compression Garments: It's notable that you continue to wear compression garments nearly a year and a half post-surgery. While these can be beneficial in the early stages of recovery by reducing swelling and supporting the healing tissues, long-term dependence on them could indicate that there's an underlying issue needing attention, such as lymphatic disruption or unresolved swelling.

Massage Therapy: You mentioned that you have started massage therapy recently and are seeing some improvement. Massage can be very helpful for scar management as it promotes circulation and may help break down scar tissue, potentially reducing pain and stiffness. Consider continuing with regular, gentle massage and possibly consulting a therapist who specializes in post-surgical recovery or scar tissue management.

Scar Desensitization: Techniques such as gently rubbing the scar with different textures or applying low-level vibration can help reduce sensitivity and pain. This is something you can do multiple times a day.

Topical Treatments: Using silicone gel or sheets has been shown to improve the texture, color, and height of scars, which might indirectly help reduce discomfort.

Physical Therapy: A physical therapist specialized in post-operative recovery might provide exercises and treatments that can help improve tissue flexibility and reduce scar pain.

Pain Management: If the pain is severe, discussing pain management strategies with your doctor might be necessary. They can evaluate if medications or other therapies could be beneficial.

Consultation with Your Surgeon: It’s crucial to follow up with your plastic surgeon or a new one if you feel your concerns were not adequately addressed previously. They can assess the scar for any complications such as nerve involvement or tethering, and suggest appropriate treatments or interventions.

Evaluation for Neuroma: Sometimes, nerve pain in a scar can be due to a neuroma, which is a benign growth of nerve tissue. A specialist can determine if this is the cause and recommend treatment options such as corticosteroid injections or in rare cases, surgical removal.

Your situation, requiring ongoing compression and experiencing pain this long after surgery, is not typical and warrants a thorough evaluation. Ensuring that there is no underlying issue that has been overlooked is important for your comfort and health.

Keep monitoring your symptoms and advocating for yourself with healthcare providers until you find a resolution. I hope you find relief soon and can fully enjoy the benefits of your surgery.

Sincerely,

J. Timothy Katzen, MD, FASMBS, FICS
Plastic Surgeon

It is unusual to still require your compression garment and experience burning. Massage may help, but please see your surgeon for a physical examination of your concern. Your scar may require surgical revision.

IT sounds as if you are experiencing a hypertrophic or keloid scar. Quite frequently this will respond to steroid injections with relief of pain in 2-3 days. Consult with your surgeon about this option.

What you are describing is not the typical thing we would see over a year after surgery.  I would follow up with your doc and get a physical exam. If he notices anything unusual, he may want to perform an imaging study such as a CT scan, but start with the physical exam. 
Good luck,
Dr. S