Are there treatments for scar discoloration 12 months post-op or do I need a revision? (photo)

Dear Eclectic385117,

I understand you are concerned with the appearance of your scars. As your scars heal, it should flatten out and lighten. Loss of pigmentation or hyperpigmentation may also be experienced but will resolve over time. Always follow your surgeon's post operative care instructions when it comes to scar management to avoid any complications like infection and for faster healing and recovery.

Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

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

Dear Eclectic: This far post surgery, the incision looks to be as good as it is going to get non surgically. Neither dermabrasion, microdermabrasion, Cool sculpting nor Morpheus is likely to be beneficial. A surgical revision offers the best chance for a better outcome because, unlike the first operation in which the skin was closed tightly under tension, with the revision, there is much less tension on the skin edges which means that the tendency to stretch (wide scar) is lessened. You should expect a thinner scar. Unfortunately, there is no guarantee that it will look better even after a surgical revision because it is possible that you heal that way regardless of the technique or surgeon chosen. If you are opposed to surgical revision, and are otherwise happy with the contour, you might consider a professional tattoo. And for best results you should be free of all tobacco products.

Dear Virginian,
Thanks for posting your pictures and sorry for your sub optimal scar outcome. After one year from your surgery the scars achieved maturity and it will not improve further. To improve on your scars you have 2 options : 1. Tattoo light colored spots with skin tone pigmentation. Make sure to check before and after pictures of scars tattooing by the tattoo artist to make sure of good match of the pigmentation.
2. Scars revision with intra dermal continuous repair with self absorbing sutures.
All the best,
Dr Widder
widderplasticsurgery.com

At a year post op you can now consider scar revision. The photos that you provided show that the scar has widened which can occur due to tension on the scar as well as other causes. A scar revision will remove the current scar with the aim being that the new incision will have less tension and heal more favorably.

I would first ask for a scar revision to make the scar less wide. Your swelling is all gone, so it will be less tight. When sutures or tapes are removed, then start scar products. If you wind up with areas where pigment is lost again, then cosmetic (not artistic) tattooing can apply your natural color again.

Hello
There are both hyperpigmented and hypopigmented areas. The best option is scar excision and re-suturing intradermally.