Plan to use Embrace scar therapy this time around on TT incision. Should I also treat belly button with Embrace? (Photo)
Full TT revision 8 days ago. Sutures out 2 days ago. Dr placed surgical tape on TT incision, but no tape on belly button. I scar HORRIBLY and plan to try Embrace Scar therapy this time around. Should I put Embrace on belly button scar too? If this creates tension, I worry it will keep my belly button too tight? Hopeful as swelling goes down my belly button will loosen up? I want to aggressively treat the scar because my old belly button still had a bright red ring 2 years post op. Thank you!
Doctor Answers 6
Embrace is a scar management/reduction application which is designed to help linear incisions heal with an improved scar. It will not work on a circular scar like that around your belly button.
Some individuals unfortunately are predisposed to making poor scars. They can either be prone to excessive collagen production following skin injury which results in a Keloid scar - thick, lumpy, irregular. Or they have more skin pigmentation which when it heals after an incision forms a scar that is darker than the surrounding skin.
Anything that delays the wound healing process resulting in prolonged inflammation can result in poor scar. Closing the incision around the belly button is the last thing that gets done in a tummy tuck operation and frequently it does not get the attention if deserves. If the surgeon does not close the incision carefully to ensure it heals optimally then the result can be a poor scar. Minimizing tension on incisions also makes for better scars, but due to the nature of tummy tuck surgery where the skin is pulled down tight, it is almost impossible to minimize tension on the belly button.
In your photo the scar around the belly button looks relatively large in diameter and it is protruding. A larger circular incision is easier to close, but it makes for an unattractive belly button. Your belly button closure appears to violate two important principles in creating an attractive belly button - shortening the belly button stalk so that it indents the surrounding skin which tends to hide the scar, and making the belly button smaller rather than larger because the tensions on the belly button tend to expand it over time.
About the only that I could suggest for you would be the consistent and prolonged application of a silicone based scar treatment such as a silicone strip or patch. There is real scientific evidence that these types of treatments do help scar quality. Some surgeons put surgical tape on the incisions which is a similar principle but I don't know if it has ever really been shown to be effective. BioCorneum is another type of silicone treatment that is in a cream base that is applied to the scar twice a day. There is good scientific evidence that this treatment is effective and it it easy to use so patients are more likely to use it consistently. We generally get very positive feedback from patients on this product.
Some individuals unfortunately are predisposed to making poor scars. They can either be prone to excessive collagen production following skin injury which results in a Keloid scar - thick, lumpy, irregular. Or they have more skin pigmentation which when it heals after an incision forms a scar that is darker than the surrounding skin.
Anything that delays the wound healing process resulting in prolonged inflammation can result in poor scar. Closing the incision around the belly button is the last thing that gets done in a tummy tuck operation and frequently it does not get the attention if deserves. If the surgeon does not close the incision carefully to ensure it heals optimally then the result can be a poor scar. Minimizing tension on incisions also makes for better scars, but due to the nature of tummy tuck surgery where the skin is pulled down tight, it is almost impossible to minimize tension on the belly button.
In your photo the scar around the belly button looks relatively large in diameter and it is protruding. A larger circular incision is easier to close, but it makes for an unattractive belly button. Your belly button closure appears to violate two important principles in creating an attractive belly button - shortening the belly button stalk so that it indents the surrounding skin which tends to hide the scar, and making the belly button smaller rather than larger because the tensions on the belly button tend to expand it over time.
About the only that I could suggest for you would be the consistent and prolonged application of a silicone based scar treatment such as a silicone strip or patch. There is real scientific evidence that these types of treatments do help scar quality. Some surgeons put surgical tape on the incisions which is a similar principle but I don't know if it has ever really been shown to be effective. BioCorneum is another type of silicone treatment that is in a cream base that is applied to the scar twice a day. There is good scientific evidence that this treatment is effective and it it easy to use so patients are more likely to use it consistently. We generally get very positive feedback from patients on this product.
Embrace Scar Therapy pads are designed to take tension off linear scars by they way they load tension prior to placement of the pad. Thus, it is not designed to help with a circular scar like a belly button. Most of the time, we recommend a silicone gel that can be massaged into the belly button twice a day to help with scarring around the belly button. Sun protection will also help reduce the darkening of the belly button scar in the post-operative period.
Learn more: http://www.drhasen.com/procedures/tummy-tuck.cfm
Embrace is a great product that we use in our practice to improve linear scars. It works by combining the benefits of silicone with the ability to relieve tension on the wound which is a major contributor to excessive scar formation. Because the belly button incision is round the embrace wouldn't be able to relieve that tension and it could potentially trap moisture in the area causing maceration. An alternative is Biocorneum which is a silicone scar gel which would be much easier to apply around the belly button.
Good luck.
Good luck.
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Midline scars, like the scar around the belly button, have a higher incidence of forming hypertrophic scars and for that reason we started pretreating that scar and any other scars on patients that scar badly with a dilute steroid (kenalog 2.5%) both during and after surgery as well as encouraging our patients to follow up with a post op scar treatment. there are many of those available and I'm sure we each have our favorites. Ours is BioCorneum. To date we have had no complications by using the Kenalog injections at the time of surgery and then moving up to Kenalog 10% injections every 6-8 weeks after surgery until the scar looks appropriate. Your surgeon will be familiar with this treatment as it is a mainstay of scar therapy.
I would use a combination approach including Plato's Scar Serum, pulsed dye laser, tension release, and fractional laser with PRP vs. Embrace scar patches.
Best,
Dr. Karamanoukian
#Realself100 Surgeon
Learn more: http://keloidexpert.com/the-scar-expert/scar-before-and-after-photos/
Thanks for your question. This comes up a lot with my patients too. If you have the tape available then placing it onto the belly button might do some good. Embrace is designed to work across long incisions. I can see that it could benefit patients in round incisions so if they already purchased the tape I ask them to place it on any scar. Side effects are minimal. Best, Dr. Aldo
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.
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