Is my scar hypertrophic & do I have scar tissue? (Photo)

Abdominoplasty scars can be quite complex, ranging from the simple hypertrophic scar to a multiplane inflamed keloid. Pigmentation, discoloration, chronic inflammation, scar visibility can all occur in the short term. We begin each treatment with combination therapy using Yellow broadband BBL, Vbeam, fractional erbium, intralesional IIT, and scar modulation. Start with a combination of Plato's Scar Serum massaged twice daily after one week of epithelialization followed by Luminase/Exfolase. Scar consultation and revision may be recommended.

Best,
Dr. Karamanoukian
Realself100 Surgeon

You have red, hypertrophic scars, likely from extreme tension on the tummy tuck closure. It's clear from the fact you have BOTH a high transverse scar and a vertical dart that the surgeon tried very hard to cut out more skin but couldn't. I advise against the usual therapeutic plan of corticosteroid injection because they will cause scar widening and likely not make much of a difference in scar color. I advise waiting, possibly up to one year or more until you have regain some minimal amount of laxity. At that time you should consider surgical scar revision and post surgical tape therapy for 3 to 6 months. Any GI issues you are having has nothing to do with your tummy tuck.

Dear Gorgeous214926,
I understand your concern. However, without a proper assessment, it would be difficult to determine what went wrong. It is best that you visit your plastic surgeon for further assessment or ask for a second opinion. Only after a thorough examination, you can get proper recommendations and advice.
Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Yes it appears you have some areas of hypertrophic scar. If silicone sheets and other interventions have been used consistently and not improved the area you can consider steroid injections. You can also consider scar revision at this point. See your surgeon for further recommendation.

Dear Gorgeous,
Your tummy tuck scars do appear to be hypertrophic in areas, especially around the belly button. Keep using your scar gels and tape, massage, and follow your plastic surgeon's recommendations. Scars can take 2 years or more to fully mature. The scars have nothing whatsoever to do with your GI difficulties and you should see your PMD for that issue. Good luck!

Abdominal incisions take 12 to 18 months to mature. For patience or form hypertrophic scars it can take longer.
The process of scar hypertrophy is an imbalance between the body generating more scar tissue than necessary and the factors that create scar maturation are slightly out of balance.
The best way to manage this is to minimize anything that causes inflammation. Number one on the list is to never ever scratch healing scars even if the inch. and this sense I sometimes question if massage is a good idea because even microscopic stimulation for inflammation can chronically make scars worse. I know a lot of plastic surgeons recommend massaging but there’s very little evidence that it works.
Personally I’m a really big believer in the body‘s ability to heal well if left to its own device.
I am a fan of silicon tape used consistently until hypertrophy has improved sufficiently.
Make sure note tight clothing is pressing against the scar and especially rubbing against it.
Well it may seem like things should’ve improved this far out the truth is you are not at your maturation point and your scores did not reflect what they will look like long-term.
And individuals with hypertrophic scars you may need to wait two full years before you really know what the scars will look like.
Personally I do a scar inventory or scar history on all patients before doing surgery. this means I asked patients and search for any areas on their body would have had previous scar formation. This would be any other area where they’ve had surgery injuries or anything leading to the skin needing to heal.
Individuals who are at risk for hypertrophic scar information should have a more thorough discussion about disability of scars after and should be managed with the hands on approach by surgeons for longer periods of time than those who do not form hypertrophic scars.
Stay away from things like laser treatments and while anti-inflammatory steroid injections are extremely powerful in stopping the hypertrophy they can also cause thinning of the scar with the scar becoming wide.
Steroid injections might be indicated in some individuals but should be done extremely conservatively and never in close intervals. they can be very successful but can also cause scars to widen substantially.
When considering steroid injections make sure anybody doing it is extremely conservative and has lots of experience.
Unless the hypertrophy is extreme it’s better to avoid steroid injections.
There are also topical anti inflammatory steroid scar preparation‘s that could be considered.
Continue following up with your provider and recognize that your scar is not mature yet and this is not your final outcome.
It’s important for plastic surgeons to do a scar history or inventory because those at risk for hypertrophic scars may want to have reconsideration of having the procedure.
For now it sounds like you’re doing all the right things you just simply need to give it more time.
Best,
Mats Hagstrom MD