Tummy tuck 7 years ago & scar is thick & feels lumpy on some places, what to do?

Question

I had a tummy tuck 7 years ago. the scar is thick and feels lumpy on some places when you touch it! It's also hyper pigmented. I don't know what to do. Prp treatment? O2 laser? I need help

Raffy Karamanoukian, MD, FACS · Answer

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

Best, 
Dr. Karamanoukian
Realself100 Surgeon

Daniel Barrett, MD · Answer

Dear Calvadoll19,

it is hard to tell for sure without an examination. If you are considering treatment, I would suggest you consult a board-certified plastic surgeon. Only after a thorough examination, you will get more information and recommendations.

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

Ira H. Rex III, MD · Answer

There are a number of options here.  None of which are always helpful or predictable.  And most treatments have risks.  To get the most improvement, complete excision and perhaps early radiation treatment may provide excellent results.  This is very aggressive, and you may still have regrowth of excessive scar.  The resulting scar could potentially be worse.  You should consider visiting your plastic surgeon to evaluate the options and especially your expectations of improvement.  This would dictate which different methods may be considered.

Robert M. Wald, Jr., MD · Answer

Your scar has widened following this procedure. Th lumps are due to scar tissue. A laser may make the scar lighter, but the lumps will still be present. The best improvement would be to do a scar revision. This would improve the overall appearance of the scar and remove the lumps.

Camille Cash, MD · Answer

You can consider having a scar revision.  Essentially the current scar is removed with the intention that the new scar will have less tension on it and heal more favorably.  I've included a video on scar revision that I hope you find helpful.

Connie Hiers, MD, FACS · Answer

You may have thick scarring or even a keloid. Go back to your surgeon and see if Kenalog injections might be helpful.

Mats Hagstrom, MD (license on probation) · Answer

Before considering scar treatments, it’s important to first get quality assessment to understand what the problem is.
Scar issues typically come down to a few different variables.
In terms of the character of the scar itself problems can often be divided into scar hypertrophy or keloid type scars which are thick and hard or hyperpigmentation the problem is purely skin color, not shape or texture.
For scar hypertrophy silicone sheeting that can be helpful, but it typically needs to be used for many months before it has an impact.
Scar hyperpigmentation is more challenging and will not typically be improved from the silicone sheeting.
For most individuals hyperpigmentation subsides with time, but when it’s present for more than two years, it may be difficult to reverse.
Sometimes laser treatments can be helpful, but if done incorrectly on the wrong patients Laser treatments can potentially also make things worse.
Whenever we consider revision, we need to ask ourselves will scar heal different differently by redoing the surgery.
In your case, there may be different scar issues and each one may need to be assessed differently.
I don’t think PRP will do much and. CO2 laser may not be the best option for hyperpigmentation. 
I suggest having a few in person consultations with plastic surgeons in your community.
Simply redoing the scar is not a guarantee that it’s going to heal better.
 Lumpiness or nodules in a tummy tuck scar may result from larger sutures used to sew together the skin edges, which are usually had significant tension during the first procedure. 
Best,
Mats Hagström MD

Tummy tuck 7 years ago & scar is thick & feels lumpy on some places, what to do?

Answers (7)

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