I had a full tummy tuck with muscle repair done in 2018 then had a revision in 2021. Both times I had hypersensitivity to dissolvable sutures that caused hypertrophic scarring where the sutures were placed. I am wanting to get the scar revised however do not want to risk the same issue occurring. Can regular sutures be used for individuals with hypersensitivity.
November 1, 2023
Answer: Scar hypertrophy Scar hypertrophy is generally genetically determined. During the maturation of scar tissue, the body creates a balance between creating scar tissue and breaking down or the maturation of scar tissue. Individuals prone to hypertrophic, scars, or keloid scar formation typically have an imbalance in these two factors. Your body is likely to react to any suture material with the same amount of inflammation. The final skin closure can be done with staples, but staples tend to leave crosshatch type scars. Deep sutures are still needed. Hypertrophic scars should be managed with silicone sheeting, and if severe enough consider do use of anti-inflammatory steroid injections though steroids have certain potential negative implications as wellUnless something is done differently a scar revision, for the sake of doing a scar revision is not going to change the outcome. It’s important to take healing history into consideration before contemplating surgery involving long skin incisions. Individuals who are prone to hypertrophic scarring often have a history of abnormal healing from even minor injuries, or even reactions to things like acne. For some individuals doing scar revisions, isn’t going to improve the final outcome. The decision of how scars should be managed needs to be done carefully with insight and proper understanding of how individuals heal, and all the variables that can affect the outcome. Without seeing pictures, we can’t begin to make an assessment. I suggest you follow up with your provider or schedule in person second opinion consultations. Best, Mats Hagstrom, MD
Helpful
November 1, 2023
Answer: Scar hypertrophy Scar hypertrophy is generally genetically determined. During the maturation of scar tissue, the body creates a balance between creating scar tissue and breaking down or the maturation of scar tissue. Individuals prone to hypertrophic, scars, or keloid scar formation typically have an imbalance in these two factors. Your body is likely to react to any suture material with the same amount of inflammation. The final skin closure can be done with staples, but staples tend to leave crosshatch type scars. Deep sutures are still needed. Hypertrophic scars should be managed with silicone sheeting, and if severe enough consider do use of anti-inflammatory steroid injections though steroids have certain potential negative implications as wellUnless something is done differently a scar revision, for the sake of doing a scar revision is not going to change the outcome. It’s important to take healing history into consideration before contemplating surgery involving long skin incisions. Individuals who are prone to hypertrophic scarring often have a history of abnormal healing from even minor injuries, or even reactions to things like acne. For some individuals doing scar revisions, isn’t going to improve the final outcome. The decision of how scars should be managed needs to be done carefully with insight and proper understanding of how individuals heal, and all the variables that can affect the outcome. Without seeing pictures, we can’t begin to make an assessment. I suggest you follow up with your provider or schedule in person second opinion consultations. Best, Mats Hagstrom, MD
Helpful