I'm Asian, How Can I Minimize the Dark Scarring That Happens Due to the Pigment of my Skin? (photo)

I'm scheduled for a tummy tuck and a breast augmentation. My main concern is the TT scar and trying to make that scar look as best (thin and light) as I can. I want to be realistic about my expectations. Thank you.

Doctor Answers 9

Pigmentation with surgery.

Thanks for sharing. You should probably avoid tanning and direct sun exposure fro about 1 year, use silicone sheets or other scar care method and talk to you PS about hydroquinione. Best of luck, Dr. Aldo.

Scottsdale Plastic Surgeon
4.9 out of 5 stars 202 reviews

Pigment Changes after Tummy Tuck Surgery?

Thank you for the question and picture.

You are wise in  attempting to achieve realistic expectations prior to undergoing tummy tuck surgery. I'm sure you are aware, that despite best efforts, pigment changes may occur. These pigment changes do seem to be more frequent depending on the patient's ethnicity. The  pigment changes often resolve/improve with ongoing time, but may take many years to fade.

 Generally speaking, the use of pressure ( tape) and/or the use of silicone -based products may be helpful in improving the appearance of scars.

 Of course, your plastic surgeon will likely have his/her own protocol/advice.

 Best wishes.

Tom J. Pousti, MD, FACS
San Diego Plastic Surgeon
5.0 out of 5 stars 1,502 reviews

Dark skin and pigment changes after surgery

I have operated on many people with darker pigment in their skin. The key is to be upfront with the possibility of skin color changes. There are many things that can help with scar formation and discoloration. Silicone based gel and strips are great for the first 6-8wks and protection from the sun at all times is a must. If however this does not work there are several laser that can take out pigment form scars including the pulsed dye laser as well as the harmony laser. I hope this helps and good luck. 

Ritu Chopra, MD
Beverly Hills Plastic Surgeon
5.0 out of 5 stars 33 reviews

Hyperpigmented Post Abdominoplasty Scar On Asian - Treatment?

Post operative abdominoplasty scarring with or without hyperpigmentation should be treated with paper tape or steri strips.  My favorite steri strips are Proxi strips.  They should be used 24/7 after all scabs are off your abdominoplasty incision.  This decreases the chance of hypertrophy (thickening) of the scar.  This taping of the suture line, in my practice, is done by me every two weeks.  This allows both myself and the patient to see the progress, and if there is a problem, it can be treated instantly.  The taping usually continues for about 3 months.  I believe surgery doesn't end at surgery.  It ends when the patient has the best possible scar for her genetics.

With reference to hyperpigmentation, I have found most bleaching creams to be of little value.  In my practice, we use a bleaching cream that has as its main component Kojic acid.  This is also the basis of the Mommy Makeover cream we use for melasma (the mask of pregnancy). 

Each plastic surgeon has his or her own techniques for treating post op scarring and hyperpigmentation.   I recommend you speak to your plastic surgeon about his or her technique and about your concerns.

How Can I Minimize the Dark Scarring

From the looks of your photo, you can expect a nice result. Most scars heal nicely. There are remedies for the odd scars that are thick or dark. For hypertrophic (thick) scars, injection with kenalog has been the gold standard. There are a multitude of scar creams on the market. Some lasers can improve hypertrophic scars if they occur.

For hyperpigmentation, fade creams with 4% hydroquinone (prescription strength) has been effective, as well as some lasers.

Thanks for your question, best wishes.

Jourdan Gottlieb, MD
Seattle Plastic Surgeon
4.6 out of 5 stars 45 reviews

Minimizing scarring?

Hello! Thank you for the question! It is common for scars to fully mature for up to a year. In the meantime, there are a few things that may help to ameliorate your incision/scar. The most proven (as well as cheapest) modality is simple scar massage. Applying pressure and massaging the well-healed scar has been shown to improve the appearance as it breaks up the scar tissue, hopefully producing the finest scar as possible. Other things that have been shown to add some benefit, albeit controversial, are silicone sheets, hydration, and topical steroids. I typically allow after 4-6 weeks postop and once fully healed. In addition, avoidance of direct sunlight to the incision will significantly help the appearance as they tend to discolor with UV light during the healing process.

If unsightly scars are still present after approximately a year's time, other things that your surgeon may consider are intralesional steroid injections, laser, or just surgical revision of the scar itself. Lasers may also be an option for the appearance of your scars. If still no result, consideration for lasers, steroids, or scar revision may be entertained. Best wishes!

Lewis Albert Andres, MD
Scottsdale Plastic Surgeon
5.0 out of 5 stars 26 reviews

There are some things that can be controlled for a better incision appearance


Thank you for the question and the photo.  From your photo it does not appear that you would be at any significant increased risk for dark scars.  With that said there are somethings that can be controlled and some things that cannot.  Obviously you cannot control your genetics but your plastic surgeon can use suture that is less inflammatory and close your abdomen with less tension to allow for better incision healing.  You may use silicone tape in the recovery period to help with scarring and once everything has healed some medication creams are available for scar lightening if that should be needed.  The link below is from one of my patients with a much darker Asian origin skin type.

All the best,

Dr Remus Repta

Remus Repta, MD
Scottsdale Plastic Surgeon
4.9 out of 5 stars 166 reviews

Dark Scars after Mommy Makeover

   If dark scars form after mommy makeover, they will fade over a year's timeBleaching can be helpful later on.  There is no one great scar cream or material, but silicone sheeting is cheap and has a long track record in treating in burn scars and poor scars.

Kenneth B. Hughes, MD
Los Angeles Plastic Surgeon
4.9 out of 5 stars 496 reviews

Pigmentation after surgery

Asian patients and all patients of darker complexion may have darkening of their scars after surgery.  Pigment is produced in response to the inflammation of the skin that happens during the healing process.

Most of the time, this darkening improves with time.  If the darkening does not improve, bleaching creams containing hydroquinone in combination with Intense Pulsed Light (IPL) can remove the pigment in most instances.  IPL is similar to a laser treatment.  It targets pigment in the skin and is typically used for photofacials to remove sun induced pigmentation of the face.

I would advise that you discuss your concerns with your surgeon prior to surgery.  He or she will probably have their own ways to deal with this issue.

Shim Ching, MD
Honolulu Plastic Surgeon
4.6 out of 5 stars 48 reviews

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.