Will the Thickness of Tummy Tuck Scar Tissue Soften and Become Less Ugly?

Question

Hi! I had my tummy tuck 4/8/11 - 5 months ago. Although I am very happy with the results, I notice that my scar in some areas is thicker than I have seen on other women. I know it takes over a year to heal, but I am wondering if I am always going to have such a thick ugly scar. The thick part will be hidden in my bikini. I will take the scar over my old saggy tummy, but wonder if you have any advice? Thank you!

Michelle Spring, MD, FACS · Answer

While scars do keep maturing over time (a year or more), it looks like yours is hypertrophic. Steroid injections into the scar may improve it - I would followup with your plastic surgeon to talk about this.

Lewis Albert Andres, MD · Answer

Hello! Thank you for the question! It is common for scars to fully mature for up to a year. In the meantime, there are a few things that may help to ameliorate your incision/scar. The most proven (as well as cheapest) modality is simple scar massage. Applying pressure and massaging the well-healed scar has been shown to improve the appearance as it breaks up the scar tissue, hopefully producing the finest scar as possible. Other things that have been shown to add some benefit, albeit controversial, are silicone sheets, hydration, and topical steroids. These can usually be started at approximately 3-4 weeks postop and when incisions healed. In addition, avoidance of direct sunlight to the incision will significantly help the appearance as they tend to discolor with UV light during the healing process.  Scars will never disappear, but attempt is made to make the finest scar in a concealed location.  Incisions may be revised to lower or conceal better if enough laxity exists. If unsightly scars are still present after approximately a year's time, other things that your surgeon may consider are intralesional steroid injections, laser, or just surgical revision of the scar itself. Hope that this helps! Best wishes!

Jerome Edelstein, MD · Answer

There is no harm in using scar reduction products, such as silicone sheeting, though the best healing "product" is your body. It works to naturally reduce scarring. Redness and a raised texture are normal during the three to six months following your tummy tuck, but both traits begin to subside during the healing process. Your scars will soften and this can take about a year.For hypertrophic scarring, you can consider nonsurgical treatments.

Pablo Prichard, MD · Answer

Thank you for your post. In tummy tuck and other lift/tightening surgeries, tension is the enemy. The scar is healing gradually over 12 weeks or so, and until it is strong, it is the weakest link. As there is a great deal of tension in tummy tucks, body lifts, breast lifts, etc., the scar is at high risk of 'stretching' or widening. Silicone sheeting, although having the ability to make a scar flat, does nothing to prevent stretching of the scar. Creams or steroids or lasers also do not have the ability to prevent stretching of the scar. Those are used if scar is thick or dark, but not to reduce the wideness of the scar, which is the main problem. Massage also does not help keep the scar thin, and can actually worsen the scar in the first 12 weeks because you are actually adding tension to the scar. Massage is for softening a hard or thick scar, but if used early, will hasten the scar widening. Only tension reduction has the ability to keep the scar as thin as possible. You may notice in a lot of tummy tuck scars that the center portion of the scar is the widest with the sides toward the hips being the thinnest. This is because the maximum tension is at the center, and least amount on the sides. Embrace removes a lot of the tension by putting more tension on the skin on either side of the incision and drawing the incision together. It is expensive though at about $100 per week for 12 weeks. When patients do not want to spend the money for embrace, I tape the incision trying to remove as much tension as possible for 12 weeks and recommend no stretching back and to sit most of the time, keeping tension off the scar.Best wishes,Pablo Prichard, MD

Jeffrey Zwiren, MD · Answer

The belly button is really the most noticeable scar from an abdominoplasty. You can cover the lower transverse scar but the belly button is right out there. It appears that you have a hypertrophic scar which may be due to tension in both areas. At this point some judicious use of Kenalog and 5- FU may be beneficial. Otherwise you may need a scar revision in the future in this area. I have my patients place a Mack's silicone ear plug in their umbilicus. Silicone has been shown to decrease scarring and improve healing. Silcone gel sheeting is good for the low transverse scar.

Michael A. Fiorillo, MD · Answer

The Tummy Tuck Scar can fade up to a year, in some cases it may be a little longer, every case is different. I recommend my patients use a good scar care creme and massage the scar gently but firmly two times a day for 10 minutes.

Christopher L. Hess, MD · Answer

Although it's a bit difficult to tell from the pictures I think you have a hypertrophic scar.  If the current scar is within the boundaries of the original scar, is raised, firm, red to brown and may occasionally itch, burn or otherwise cause discomfort it is likely a hypertrophic scar.  This scars typically show up 4-6 weeks after the surgery and are more common in moderately dark skin, such as Asians and Hispanics.  I am quick to treat these with intrascar injection of low dose steroids.  Although this could cause the scar to become hypopigmented or lighter than the surrounding skin, I feel that the softening and reduction in size of the scar is worth it.

	It's not too late to get injected so see your plastic surgeon as soon as you can.

Daniel Sherick, MD · Answer

This is indeed a hypertrophic scar. I agree with the other surgeons that time is the best treatment. Often after a year or two a scar like this will become much more acceptable. I would suggest that steroid tape is easy to use and much less painful than steroid injections, when it works. You could ask your physician if they have experience with these tapes an find them beneficial. One brand name is "Cordran Tape," but the brand is unimportant. Enjoy your Tummy Tuck!!

Adam Hamawy, MD · Answer

There are a few thing you can do to improve the appearance of the scars after a tummy tuch or really any plastic surgery procedure:

	
		Be patient.  Scars can take up to 12 months to mature and almost always look better over time.
	
		Scar massage.  Taking 5 minutes twice a day to rub and massage your scar with you fingers can help soften and move along the maturation process.
	
		Sun protection.  Scars are more sensitive to UV radiation from sunlight or tanning beds.  Keep them covered with clothing or regular use sunscreen.
	
		Scar gels.  There are several commercial product that contain a silicone base that can be applied to scars that have been shown to be very effective.  
	
		Silicone sheets.   Placing silicone pads over scars is a gold standard in scar management therapy.  However, in order to be effective, the sheet has to be on the scar almost 24 hours a day and is difficult for most patients to be consistant with this for more than few weeks.
	
		Sterioid injection.  Steroids can help break up and soften scars, however too much can result in scar depression and also effect and damage the sarrounding normal tissue.  This should be used very sparingly.
	
		Scar revision.  Finally, the ultimate last resort is to surgically remove the scar and start over, replacing it with another that is hopefully under less tension.  The techniques listed above can then be used right from the start to avoid a poor scar from redeveloping.


	Consult with your plastic surgeon about what options are best for you.

Tom J. Pousti, MD · Answer

Yes, tummy tuck scars usually get better with time.. sometimes taking longer than 1 year. Sometimes steroid injections help. Sometimes just being patient is the best thing to do. I think you have a good attitude about the scar being hidden and that you will take a scar over the "old saggy tummy"..

Will the Thickness of Tummy Tuck Scar Tissue Soften and Become Less Ugly?

Answers (12)

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