Tummy Tuck Scar After 10 Weeks - Hyperpigmentation Problem

Ten weeks ago I had a full Tummy Tuck, and 4 weeks after, I had a small correction of hematoma that didn't heal and the skin was peeled off. Around this correction, hyperpigmentation started, and now it looks really ugly. Is it normal to get hyperpigmentation in this area post-Tummy Tuck, and will it fade away in time? What can I do to make it disappear?

Doctor Answers 17

Abdominoplasty Tummy Scars: What makes a good scar

The look of an abdominoplasty scar is dependent on a number of factors, including genetics, skin complexion, timing of recovery, quality of postoperative care, and the type of repair.

Abdominoplasty scars can hyperpigment in the immediate postoperative period. However, the long term results of a scar depend primarily on the quality of the repair. Skin and subcutaneous suturing in layers generally creates better scars than a single layered closure. This is specifically what plastic surgeons spend years training for. Make sure you go to a board certified plastic surgeon and that they take time to explain the type of repair and the postoperative care needed.

If hyperpigmentation develops, topical creams and laser are used to fade the scar.

Los Angeles Plastic Surgeon
4.8 out of 5 stars 94 reviews

Take small steps first


I understand your concern about your scar- but your interests and final outcome will be best served by exercising as much patience as you can muster... human scars mature over the first 12-18 months after they are created, meaning that for that time period, the scars will improve in appearance on their own (even if nothing were done). After this time period, you can be confident that no further improvement will occur, and intervention would be appropriate.

I don't blame you if you don't want to wait that long to see some improvement, but because the scar will be undergoing this improvement over that time, anything you do will affect this normal maturation process- so be careful, and don't be too aggressive too early in the process.

I usually recommend simple, easy, low risk scar treatments first- even if you don't get the complete improvement you wanted from them, the low risk nature of these options will mean it's unlikely you'll regret them later too- and you haven't burnt other bridges either. Examples of these kinds of simple things are Scarguard gel, Silicone tape, and Abdo-patches (from Medical Z).

If these interventions don't give you the improvement you want, then you can consider IPL (intense pulsed light) treatments or other options like bleaching creams.

Remember- the scar is likely to improve significantly on its own- the best thing to do is to try not to get in its way.

Happy Holidays!

Armando Soto, MD, FACS
Orlando Plastic Surgeon
4.8 out of 5 stars 159 reviews

Pigment fades


Pigmentation in scars after tummy tuck is very common. It usually continues to fade with time, even as far out as years after surgery. There are bleaching creams that may help to speed up the process. Also, don't forget to avoid sun exposure to your scars, as this will tend to make them hyperpigment even further. Good luck!

Kenneth R. Francis, MD, FACS
Manhattan Plastic Surgeon
4.6 out of 5 stars 48 reviews

Overtreatment of scars

Is the scar you have (inverted-T) all the result of surgery? It looks as if you might have hyperemia or redness of the scars due to hypervascularity rather than hyperpigmentation due to melanocyes and melanin. One easy test is to press on the scar with your two index fingers and then move them along the scar away from each other to see if the scar blanches. If you can press the color out, it is due to hyperemia and should improve over time. Patients often rushing into laser treatments prematurely and end up making things worse. Time is on your side. Meanwhile, I would try silicone sheeting which is a low cost, low risk treatement for hypertrophic scars. Discuss this with your surgeon.

Robin T.W. Yuan, MD
Beverly Hills Plastic Surgeon
5.0 out of 5 stars 11 reviews

Hematoma worsens hyperpigmentation but it will fade

Any amount of subcutaneous blood such as a hematoma can cause pigmentation or hyperpigmentation, espceially in a person with a darker skin. this will usually fade over 9 month.

it is critical to avoid sun bathing or tanning during this period in order to avoid permanenet hyperpigmentation.

keeping the skin moist with oily lubricants helps the health of the skin during this period. some doctors feel that bleaching creams such as Hydroquinon are effective but in my opinion they don't make a lasting difference. It just takes time!

Sean Younai, MD Beautifulfigure.com

Sean Younai, MD, FACS
Beverly Hills Plastic Surgeon
4.4 out of 5 stars 49 reviews

Scar Guard and Laser will be helpful

I am not certain from your photo if you already had a vertical scar, or if you had some skin necrosis that left an abnormal scar. Either way, your scar will improve with time. You can speed up the process with two modalities.

The first would be a product called Scar Guard. It is now available at most pharmacies and many Plastic Surgeons carry it in their office. It is painted on the scar 1-2 times per day. It is a combination of silicone gel, vitamin E, and other products. We have used the product for all of our patients post op and have great results.

Pulsed Dye or IPL laser would reduce the redness very quickly. Normally 2-3 treatments are necessary. It is done in the office and requires no anesthesia.

Discuss these issues with your surgeon to find out the best course of action

Have a great holiday and Merry Christmas

David A. Dreyfuss, MD
Orland Park Plastic Surgeon
4.7 out of 5 stars 3 reviews

Laser treatments an option

It appears that you had some pre-existing scarring from earlier surgery so your case is a bit complicated. There are some laser treatments and a similar one called IPL (Intense Pulsed Light) which can help scars to fade if it is started early.

Richard Baxter, MD
Seattle Plastic Surgeon
4.9 out of 5 stars 54 reviews

Time is your friend

Time is the most important thing at the 10 week stage of scar healing.

You can also try silicone sheeting or topical products like ScarGuard and Mederma. Those can be used now.

Scar revision is something that could be considered (this includes laser, steroid or additional surgery). You may be suprised at how well the scar settles with time though.

Good luck and let us all know how things work out.

Steven H. Williams, MD
San Francisco Plastic Surgeon
4.8 out of 5 stars 49 reviews

Silicone sheeting for scar treatment

Your best treatment options include:

  1. Massage
  2. Sunblock
  3. Silicone sheeting
  4. Laser scar reduction
  5. Time!

Robert M. Freund, MD
New York Plastic Surgeon
4.8 out of 5 stars 33 reviews

Scars will improve

While your result looks like you have a bit of a nasty scar right now, if we could project you one to two years down the road, you would see a dramatic improvement in the scar and hyperpigmentation. Scar massage, possible IPL treatments may speed the resolution a bit also.

Richard P. Rand, MD, FACS
Seattle Plastic Surgeon
4.8 out of 5 stars 67 reviews

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.