Scar revision for tummy tuck? (Photo)

Question

Hi please can I get advice on this scar. The clinic I had surgery at is saying it’s hypertrophic and it’s the way I’ve healed. I don’t think it’s HP. What has gone wrong? Please advise me. Thankyou

Benjamin Baker, BMBS MBA FRCS(Plast) · Answer

Hi, thanks for your question. It is difficult to be sure from the photos alone, but the scar looks stretched rather than hypertrophic. This can be due to a number of factors including operative technique, how much tension the tissue was under at the time of closure, patient characteristics, and post-op wound care. I would leave it at least 6-12 months before considering any kind of revisional work - you could consider corrective surgery or non-operative methods to camouflage or improve the hyperpigmentation. I would recommend a face to face consult with a specialist plastic surgeon.

Raffy Karamanoukian, MD, FACS · Answer

Our office has many different treatments for scars depending on the depth of atrophy or hypertrophy. Scars require a combination approach using our HI DEF protocol which uses a combination of lasers, topical scar modulation, and RF treatments to pixelate scars, improve contour, reduce hyperpigmentation, and improve the visibility of the scars so that they are no longer visible in ambient light. Everyone has a unique pattern of scarring and we employ our HIDEF technique to improve texture, color, contour, and topography. We often use a combination of treatments that begin with a careful examination to examine the micro texturing of the acne scars. Atrophic scars and indented  scars can benefit from injectable fillers such as Radiesse, Sculptra, and Restylane with or without subcision to remove tethered scars and atrophic depression. Hyper-redness in scars can be improved with V beam laser, Excel V, BBL, IPL, and Venus RF to improve  the redness and reduce the visibility of deep scars. Fractional Thulium laser and clear & brilliant can also reduce the inflammation and redness of the scar when combined with topical therapy. Fractional lasers such as Fraxel, erbium, and CO2 laser can be combined with radio frequency and also fractional RF to improve textual issues and microtopography. Subcision and TCA cross are also used for deep ice pick scars and narrow valley scars in order to improve the micro texture.  Above all, our combination approach with our clinical nurses and board-certified plastic surgeons can improve the quality of your skin by using at home Melarase creams combined with PRP treatments in our office to improve your skin quality and tone. I recommend getting a formal evaluation with an experienced team of experts in order to reduce your scarring.
 
Finally, hyperpigmentation of scars can be improved with at-home Melarase AM, Melarase PM, and Melapads to help reduce active PIH and melanin deposition.

Best, 
Dr. Karamanoukian
Realself100 Surgeon

Jeff Rapaport, MD · Answer

In my opinion you have a vascular, wide,slightly hypertrophic, shinny scar.
The width and shinny, stretched aspects can only be improved with a scar revision. However, a significant change will be obtained with steroid/5 FU injections combined with a vascular laser or IPL. Try the non surgical approach first. Find a scar expert.
Jeff Rapaport MD FAAD 
Realself Hall of Fame

Scar revision for tummy tuck? (Photo)

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