Is there away to reduce or minimise the scaring after a lower body lift?

Question

I am going to have a lower and upper body lift eventually. I want to lose 30lbs more before I waste a doctors time being told come back when I reach my goal weight but I've been looking at pics of other surgeries on this site and it looks like anyone who had a lower lift was pretty much cut around their entire abdomen in a circle and leaves major scars. Does this ever fade or get better?? I'm assuming you can get the lift but never wear clothes showing the mid area again.

Larry S. Nichter, MD, MS, FACS · Answer

Best Scar Management is important to minimize or completely hide from view, the telltale signs of your surgery—namely, scars. Both you and your surgeon want you to have the most minimal scarring possible. There are many possible causes for scars that are enlarged or not healing well. Unsightly scars are most commonly due to genetics, underlying medical conditions, or improper scar/wound care. The last part is very important and patients can make a noticeable difference in their scars’ appearance by following best scar management practices. Here are some simple tips.

Scar Management tips:

Minimize tension on the scar. Steri-Strips and/or surgical tape are often placed in non-hair bearing areas at the time of surgery to minimize tension and keep pressure over the scar.  This minimizes the  stress that  can pull the scar apart (dehiscence) creating a wound and  delaying healing time, and can make the scar wider, or more “ropy”. In the first few weeks after surgery, I recommend the use of Embrace Scar Therapy which is an adherent silicone sheeting pre-stretched when applied so as to offload tension on the scar.Keep your incision site/scar clean to prevent infection. Follow your surgeon’s wound care instructions to the letter with out modification. Never apply different products then recommended without first discussing them with your surgeon. This is especially important during the first few weeks. If there are any signs of infection, contact your surgeon’s office right away and/or see your doctor or his nurse immediately. Typical signs of infection may include redness outside the immediate incision site, asymmetric swelling, and drainage, of pus, fever, chills, and “feeling sick”.Protect your scars from the sun. Staying out of the sun is the best advice. Minimal exposure to sunlight is prevents hyperpigmentation (permanently turning brown) and other problems that can make the scar more noticeable. Sunscreen, at least 30 SPF and an overlying make camouflage make up additionally protects the scar from the suns harmful rays. This advice is especially important the first year following your surgery.Use specific scar maturation products recommended by your surgeon. Patients seem to have their own opinions on this touting everything from Pure Vit E, Coco butter, to Aloe Vera, etc but most have minimal benefit other than keeping the scar hydrated. Although hydration is important there are better, scientifically studied products with greater efficacy. Most of the scientific articles written about this subject indicate that topical silicone gel or silicone sheets work the best. The best product available in my opinion is the Embrace Scar Therapy System by Neodyne BioSciences, Inc. available in many surgeons’ offices. Essentially this is an adherent silicone sheeting pre-stretched when applied so as to offload tension on the scar. For areas that are not applicable for this product (e.g. smaller areas or on the face), I prefer BioCorneum or Kelo-Cote products There are a lot of products to choose from, but silicone should be one of the key ingredients. Although Mederma, an onion extract derivative active ingredient rather than mainly silicone based may help, primarily silicone based products are better and many also contain other ingredients that may be synergistic (hydrocortisone or other steroid, Vitamin E, Sunscreen, etc).. If the reader has problems obtaining these they can call my office. Patient compliance is also critical – use often and according to directions or it will not work optimally. NEVER apply products without first discussing them with your surgeon.Monitor to make sure your scar is progressing optimally. Keep your scheduled follow-up appointments with your surgeon to verify that your scars are maturing as expected.  Occasionally if indicated you may need a topical steroid preparation or even a series of  injections (5-FU and/or Steroids) or laser treatments  to treat or  prevent scar hypertrophy or keloid formation (red raised scars), or other topical medicines to treat post inflammatory hyperpigmentation (brown scars) with prescription creams and possible laser treatments.

J. Timothy Katzen, MD, FACS · Answer

Hello, and thank you for your question regarding scarring after a lower body lift. I appreciate your thoughtful approach to planning your procedure and reaching your goal weight before surgery.

Yes, a lower body lift involves a circumferential incision around the abdomen, lower back, and sometimes extending to the hips. This is necessary to remove excess skin and reshape the body after significant weight loss. While these incisions do result in permanent scars, the good news is that with proper care and time, scarring can fade significantly and become much less noticeable.

Most patients find that their scars mature and lighten over the course of 12 to 24 months. While they will never completely disappear, there are several ways to minimize their appearance:

Silicone Gel and Silicone Sheeting – Silicone-based scar treatments, such as silicone gel (e.g., BioCorneum, Silagen, or ScarAway) or silicone sheets, are widely recommended by plastic surgeons to help flatten and soften scars.

FRAXEL Laser Treatments – If scars remain thick, raised, or dark, laser resurfacing treatments like FRAXEL can improve their texture and pigmentation over time.

Steroid or 5-FU Injections – If a scar becomes raised or hypertrophic, steroid or 5-FU injections can help flatten and soften it.

Medical-Grade Skincare – Keeping the scars moisturized with vitamin E, Mederma, or Strataderm can help improve healing.

Avoiding Sun Exposure – Keeping your scars protected from the sun is crucial. UV rays can cause hyperpigmentation, making scars more visible. Always apply sunscreen (SPF 50+) when wearing clothing that exposes the area.

Wearing Compression Garments – Compression garments after surgery help support healing and reduce tension on the incisions, which can lead to better scar formation.

Most patients find that their scars fade into a thin, pale line over time, especially when following a good scar care regimen. If scarring is a significant concern for you, discuss it with your plastic surgeon before surgery so they can place incisions in locations that can be more easily concealed by underwear or swimwear.

While you may not feel comfortable wearing clothing that fully exposes your midsection immediately after surgery, many patients feel more confident over time as their scars fade and their body contour improves.

Good luck with your weight loss journey and future body lift! I hope this helps answer your concerns about scarring.

Sincerely,
Dr. Katzen

Marie E. Montag, MD · Answer

Whenever someone has a major weight loss and needs a lower body lift it is because their skin stretched too much during the weight gaining process and lost its elasticity. As you lose weight again the skin will not shrink and retract and remains loose. The only way to get rid of the excess skin is to cut it away, and that means having scars. You trade having scars for having a better shape. Most people feel that is an acceptable trade, but it is not ideal. You can work with your surgeon while he/she is planning the incisions to try and make them as low as possible, but you will always have a scar. Genetically, some people’s scars heal better and fade more than others, and hopefully you are a good scar healer and not a keloid former, but that is out of your control. There are some things that you can do while healing that may influence your scar formation… 1.) Do not be overly active during the early healing – if you are too active you may pop stitches and worsen your scars. 2.) Once the wounds are healed and stitches are out you can apply vitamin-E oil (or other scar creams) to the scars to moisturize them and massage the scars to mechanically help break down or soften the scars (your doctor will tell  you when you can start this). 3.) Avoid sun exposure on the scars to help prevent darkening. 4.) There is also a product in the market called Embrace that helps reduce the tension across the scars and prevents widening for some people. It can get a little pricey, but if you know you tend to have scars that widen it may be worth the costs.
The best advice for you is to discuss these issues of wound healing and scar location with your surgeon at the time of your consult and he/she will be able to help you come up with a unique plan based on your goals and your anatomy. Good luck with your surgery.

Aldo Guerra, MD · Answer

Thanks for this question. The best treatment I've run into over the years is Embrace scar prevention. This is a silicone tape that reduces tension at the scar and changes the way the DNA is expressed leading to a better wound healing environment. Time and precision planning along with scar therapy will help to get a better scar. Best wishes, Dr. ALDO

Kenneth Hughes, MD · Answer

Certainly there are both technical aspects to the surgery to yield a better tighter result and postoperative elements to help with the scarring.  In addition, time and scar remodeling can change the appearance of scars.

Jonathan Weiler, MD · Answer

Lower body lifts are rarely done these days because of the scarring and the lack of long term benefit, would recommend extended TT with upper body lift and if needed a buttock lift can be a very powerful procedure with fat grafting, good luck!!

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