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

Hello. These are all great questions to ask the surgeon whom you will be selecting to perform your abdominoplasty. There are many options that can help with keloids that form, as you stated laser. But also steroid injections or the type of sutures can also be a determining factor as well.

Hello,
Thank you for the question. This is a common concern. Experienced surgeons will use appropriate technique as well as post-operative scar care management in order to reduce the incidence of keloid scarring. I wish you the best.
Vasileios Vasilakis, MD, FACSDouble Board Certified Plastic SurgeonHouston, TX.

It’s great that you’re thinking ahead about your belly button healing, that’s an important part of tummy tuck recovery. Since you’re prone to keloids, it’s smart to consider how your belly button might heal. Many patients find that while tummy tuck scars can sometimes form keloids, the belly button can often be shaped in a way that any scar is subtle and well-hidden.

If a keloid does form, there are several approaches besides laser, including silicone treatmentss, steroid injections, or other scar management techniques your surgeon can recommend. The key is close monitoring during healing to intervene early if needed.

If you’d like, we can discuss strategies to help minimize keloid formation around your belly button during your next visit.

We’d be glad to review your skin type and incision plan with you in a consultation to discuss ways to reduce scarring.

Good luck.

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.