How will my new belly button look after tummy tuck if I am keloid prone?

Any scar can be treated. The type of treatment depends on how much scarring develops. I recommend my patients to place a silicone conforming ball into the belly button as soon as the skin has healed to try to prevent excessive scarring. Other options are steroid injections, microneedling, and scar revision. It is important to keep your follow up appointments to be treated promptly and correctly.

That’s a really great question, especially since you already know you're prone to keloids. There is a possibility of keloid formation there, but not everyone who forms keloids will necessarily get one at the belly button. Aside from laser treatments, there are other options to help reduce or prevent keloids, including steroid injections (like Kenalog), silicone gels or sheets, and sometimes microneedling with PRP once the scar is fully healed (at our office we wait until around the 6 month mark). Some surgeons may also offer preventive treatments, like steroid injections during or shortly after surgery, if they know a patient has a history of keloids. Be sure to discuss your history with your surgeon, they can help create a scar management plan that’s right for you.

Keloid formation is to a certain extent unpredictable. Individuals who are keloid prone can develop aberrant scarring along any incision site as the problem stems from the unique way in which they heal.

Keloids can be treated but the have an nearly 50% recurrence rate. Options include: steroid/5Fu injections, repeat excision +/- injection, repeat excision +/- radiation therapy (which can lower recurrence rates to nearly 20%).

As always, discuss your concerns with a board certified plastic surgeon (ABPS).

This is an uncertain situation. You don't want a hypertrophic scar (most likely what you are having) or a keloid.
How will it look? not good.
Measures to minimize high risk belly button scars or abdominoplasty scars: for the transverse scar:
1) progressive tension sutures in drainless tummy tuck to minimize tension at the closure site
2) possible use of a commercial product called embrace scar therapy, a pre-stretched sticky silicon pad that pulls the skin toward the incision and unloads tension.
3) microbotox into the incision after closure, repeated at 2 weeks and two months, see reference.
For the belly button: break up the closure so it is not a closed circle. Consider a superior or inferior flap.
Aesthet Surg J. 2023 Mar 1;43(9):1015–1024. doi: 10.1093/asj/sjad044
Microtoxin for Improving Pore Size, Skin Laxity, Sebum Control, and Scars: A Roundtable on Integrating Intradermal Botulinum Toxin Type A Microdoses Into Clinical Practice
Sabrina Guillen Fabi ✉,1, Je-Young Park 2, Kate Goldie 3, Woffles Wu 4

In certain instances simply excising the scar and reclosing the wound can result in an improvement of your keloid. Unfortunately there is approximately a 50% chance that the keloid can recur and may come back even worse than before. The most reliable way to reduce recurrence is for scar revision with postoperative radiation. This type of radiation is less invasive than oncological (cancer related) radiation, still requires the help of a radiation oncologist. This intervention reduces recurrence rates to approximately 20%. Make an appointment with board certified plastic surgeon to discuss your options.

Hello,
Thank you for your question.
In patients with a known tendency to form keloids, special consideration should be given to incision placement and scar management, including around the umbilicus (belly button) after a tummy tuck (abdominoplasty). While the lower abdominal scar is typically concealed beneath clothing, the umbilical scar is more exposed and can be aesthetically challenging if abnormal scarring occurs. If a keloid develops in this area, management may include silicone gel sheets, corticosteroid injections, pressure therapy, or 5-fluorouracil (5-FU) injections, in addition to laser therapy. In some cases, surgical revision with postoperative steroid or radiation treatment may be considered to prevent recurrence. Preemptive measures such as meticulous surgical technique, early scar care, and close follow-up are key in minimizing this risk.

Hello, thank you for your question. If you are keloid-prone, then your concern about a possible keloid around the umbilicus is legitimate. Scars can be treated conservatively using massage and scar gels or other topical agents, laser, steroid injections, etc. However, none of these treatments are always effective, and they have their own potential risks (depigmentation or dark pigmentation, spider veins, thinning of the scar or the surrounding skin, burns, allergic reactions, etc). This is a very important issue to discuss with your surgeon prior to going ahead with surgery, so you can decide if the operation is right for you. Depending on your anatomy, there are alternatives to regular tummy tuck surgery that don't result in a scar around the belly button, like a mini tummy tuck, or floating umbilicus abdominoplasty (FAB tummy tuck).

Hi, Sorry to hear of your issue. There are basically two types of sutures used in surgery; those that dissolve over time and those that don't. A permanent suture, although rare, can misbehave and cause a granuloma. Removing a suture after 2 years will not impact the muscle repair in any way. Best of luck.

Yes, it’s definitely possible for someone who is prone to keloids to develop them after any surgical intervention. However, if the belly button length is adjusted properly and reconstructed without tension, the risk of keloid formation significantly decreases.
With the Mercedes technique we use, and by carefully planning the navel’s size and position, the risk of keloid formation is very rare. This method, combined with proper tension-free closure, is effective in preventing such complications.

Thanks for your question! Unfortunately, this is a risk you take. There are lasers and serums that can help, but it can't be completely avoided. You may even need a second procedure to try and reduce scarring. Best of luck!