Treatment for Tummy Tuck Scar Revision

Question

I had a tummy tuck scar revision on April 15, 2011. The surgeon placed the scar too high on my stomach and did a revision. Can the scar be brought down lower? Also, what can I do to make the scar lighter? I am hispanic and am prone to hypertrophic scarring and keloids

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

Larry S. Nichter, MD, MS, FACS · Answer

Best Scar Management is important to minimize or completely hide from view, the telltale signs of your surgery—namely, scars. Both you and your surgeon want you to have the most minimal scarring possible. There are many possible causes for scars that are enlarged or not healing well. Unsightly scars are most commonly due to genetics, underlying medical conditions, or improper scar/wound care. The last part is very important and patients can make a noticeable difference in their scars’ appearance by following best scar management practices. Here are some simple tips.
Scar Management tips:Minimize tension on the scar. Steri-Strips and/or surgical tape are often placed in non-hair bearing areas at the time of surgery to minimize tension and keep pressure over the scar.  This minimizes the  stress that  can pull the scar apart (dehiscence) creating a wound and  delaying healing time, and can make the scar wider, or more “ropy”. In the first few weeks after surgery, I recommend the use of Embrace Scar Therapy which is an adherent silicone sheeting pre-stretched when applied so as to offload tension on the scar.Keep your incision site/scar clean to prevent infection. Follow your surgeon’s wound care instructions to the letter with out modification. Never apply different products then recommended without first discussing them with your surgeon. This is especially important during the first few weeks. If there are any signs of infection, contact your surgeon’s office right away and/or see your doctor or his nurse immediately. Typical signs of infection may include redness outside the immediate incision site, asymmetric swelling, and drainage, of pus, fever, chills, and “feeling sick”.Protect your scars from the sun. Staying out of the sun is the best advice. Minimal exposure to sunlight is prevents hyperpigmentation (permanently turning brown) and other problems that can make the scar more noticeable. Sunscreen, at least 30 SPF and an overlying make camouflage make up additionally protects the scar from the suns harmful rays. This advice is especially important the first year following your surgery.Use specific scar maturation products recommended by your surgeon. Patients seem to have their own opinions on this touting everything from Pure Vit E, Coco butter, to Aloe Vera, etc but most have minimal benefit other than keeping the scar hydrated. Although hydration is important there are better, scientifically studied products with greater efficacy. Most of the scientific articles written about this subject indicate that topical silicone gel or silicone sheets work the best. The best product available in my opinion is the Embrace Scar Therapy System by Neodyne BioSciences, Inc. available in many surgeons’ offices. Essentially this is an adherent silicone sheeting pre-stretched when applied so as to offload tension on the scar. For areas that are not applicable for this product (e.g. smaller areas or on the face), I prefer BioCorneum or Kelo-Cote products There are a lot of products to choose from, but silicone should be one of the key ingredients. Although Mederma, an onion extract derivative active ingredient rather than mainly silicone based may help, primarily silicone based products are better and many also contain other ingredients that may be synergistic (hydrocortisone or other steroid, Vitamin E, Sunscreen, etc).. If the reader has problems obtaining these they can call my office. Patient compliance is also critical – use often and according to directions or it will not work optimally. NEVER apply products without first discussing them with your surgeon.Monitor to make sure your scar is progressing optimally. Keep your scheduled follow-up appointments with your surgeon to verify that your scars are maturing as expected.  Occasionally if indicated you may need a topical steroid preparation or even a series of  injections (5-FU and/or Steroids) or laser treatments  to treat or  prevent scar hypertrophy or keloid formation (red raised scars), or other topical medicines to treat post inflammatory hyperpigmentation (brown scars) with prescription creams and possible laser treatments.

Jon M. Grazer, MD, MPH, FACS · Answer

Scars look good for two weeks, then they begin to get red raised and ugly. It takes two months, to get to the firmest healing, about  six months to get to the reddest, and six months to two years to improve.

	I would start using silicone cream two weeks after surgery, two times per day. You need to do this for this for ten to twelve weeks.

	There is no laser that removes scars, if the scar is red or dark , you can use a laser to help improve the color. Bleaching creams are also sometimes helpful in darker skin types.

William Bruno, MD · Answer

You should use silicone gels/sheets right now since your scar is so new.  It is very difficult to "lower" a scar of that length.  I recommend waiting at least nine months to one year to allow the scar to mature and soften before doing any type of revision. The scar will lighten over time, you just have to be patient for now.

	Consult with your plastic surgeon if you have any further concerns.

	Best wishes,

	Dr. Bruno

Brent Moelleken, MD · Answer

You should talk to your board certified plastic surgeon about what treatments including lasers, creams, injections and sheeting might be appropriate for the care of your wound.

	See my many other posts on how the location of the tummy tuck scar is determined.  It is not something that you can just put at a low level without several other considerations.

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Treatment for Tummy Tuck Scar Revision

Answers (10)

Answer: Revising tummy tuck scars

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Everything you need to know about Tummy Tuck

Our mission is to create a world where every investment in modern beauty is Worth It.