T scar indention and length - could this scar be revised further? (Photos)

Question

I had a tummy tuck in the fall of 2023. I am extremely satisfied with the results however I did not have enough skin to remove and thus was left with a T scar. The T scar is quite long and considerably indented. I did have fat grafting done to it however, I am not pleased with the results. What are my options? Could the scar be revised or should I consider more fat grafting or filler?

Raffy Karamanoukian, MD, FACS · Answer

Our office has many different treatments for scars depending on the depth of atrophy or hypertrophy. Scars require a combination approach using our HI DEF protocol which uses a combination of lasers, topical scar modulation, and RF treatments to pixelate scars, improve contour, reduce hyperpigmentation, and improve the visibility of the scars so that they are no longer visible in ambient light. Everyone has a unique pattern of scarring and we employ our HIDEF technique to improve texture, color, contour, and topography. We often use a combination of treatments that begin with a careful examination to examine the micro texturing of the acne scars. Atrophic scars and indented scars can benefit from injectable fillers such as Radiesse, Sculptra, and Restylane with or without subcision to remove tethered scars and atrophic depression. Hyper-redness in scars can be improved with V beam laser, Excel V, BBL, IPL, and Venus RF to improve the redness and reduce the visibility of deep scars. Fractional Thulium laser and clear & brilliant can also reduce the inflammation and redness of the scar when combined with topical therapy. Fractional lasers such as Fraxel, erbium, and CO2 laser can be combined with radio frequency and also fractional RF to improve textual issues and microtopography. Subcision and TCA cross are also used for deep ice pick scars and narrow valley scars in order to improve the micro texture. Above all, our combination approach with our clinical nurses and board-certified plastic surgeons can improve the quality of your skin by using at home Melarase creams combined with PRP treatments in our office to improve your skin quality and tone. I recommend getting a formal evaluation with an experienced team of experts in order to reduce your scarring.

Finally, hyperpigmentation of scars can be improved with at-home Melarase AM, Melarase PM, and Melapads to help reduce active PIH and melanin deposition.

Best,
Dr. Karamanoukian
Realself100 Surgeon

Finally, hyperpigmentation of scars can be improved with at-home Melarase AM, Melarase PM, and Melapads to help reduce active PIH and melanin deposition.

Best, 
Dr. Karamanoukian
Realself100 Surgeon

Anna Chacon, MD, FAAD · Answer

Thank you for sharing your photos and your experience. I can imagine how frustrating it must feel to love your tummy tuck results overall, yet still be bothered by the appearance and depth of the T-scar. This is actually a fairly common concern when there wasn’t enough skin to remove during the original surgery, and there are ways to improve both the indentation and the texture.

Based on what you’ve described, here are the most helpful options:

1. Scar Revision Surgery

If the indentation is significant or the scar is stretched or tethered, a revision can help:

The surgeon can excise the scar and re-close it with improved tension and contour.

This can shorten or refine the appearance of the T, depending on how the tissues behave.

It works best once the scar has fully matured, which yours has at this stage.

This option is ideal if the indentation is caused by deeper tissue anchoring or tension lines.

2. Additional Fat Grafting

Fat grafting can still be effective if there is continued volume loss or contour irregularity.

Sometimes multiple rounds are needed, especially in areas with scar tissue where retention can be lower.

It creates a more natural, soft fill and can help blend the T-junction better.

If your first fat graft didn’t hold well, modifying the technique or layering the fat differently can make a difference.

3. Filler (Off-label Use)

For patients who prefer something less invasive, hyaluronic acid filler or a biostimulatory filler can be used to:

Lift the indentation

Smooth the contour

Reduce shadowing

It won’t replace surgery, but it can give noticeable improvement with minimal downtime.

4. Microneedling or Laser for Texture

If the main issue is also surface irregularity:

Fractionated lasers

RF microneedling
can help soften the scar and blend it into the surrounding skin.

These work best once the contour has been corrected with grafting or filler.

My overall recommendation
If the indentation is deep or tethered, scar revision often offers the most definitive improvement. If the indentation is mainly due to volume loss, additional fat grafting or filler can create a smoother, more even appearance. Many patients end up doing a combination—revision to release the tethering plus a small amount of volume correction.

Darryl J. Blinski, MD · Answer

Based on nicely posted photos, the results are acceptable though I would first attempt either SCULPRA injection and a series of up to three injections one vile per injection at a fee of $1200 per session to help increase the subcutaneous and subdermal tissue or try the new FDA approved fact raft injections ALLOCLAE one syringe fee $3500. After the healing event then possible vertical scar revision. Best virtual console with her better understanding.

T scar indention and length - could this scar be revised further? (Photos)

Answers (3)

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