What is the best tummy tuck scar therapy?

Question

I am just 3 days PO from my mommy makeover. I'm already wondering what's the best tummy tuck scar therapy. I've seen people use oils and then micropore/surgical tape, while others use silicone strips. What has worked best for you? Thanks!!

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

Scar Management tips:1- Minimize tension on the scar – Steri Strips and/or surgical tape are often placed in non-hair bearing areas 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”.
2– 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 immediately 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”.3. –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.
4. – 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. 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). At the present time I prefer BioCorneum or Kelo-Cote products and 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.
5. – 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.

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

Edwin C. Pound, III, MD · Answer

It takes about a year to a year and a half for scars to fully flatten, fade, and mature.  With that in mind, it is best to intervene early with your scar care.  There are a number of scar creams, ointments, etc. designed to improve the appearance of scars.  There are various silicone gel applications for scar improvement, however, in our office, we use BioCorneum which is not silicone based.  Microneedling is another options for scar improvement.

Erik Miles, MD, FACS · Answer

There are many techniques that different surgeons use to try to optimize the appearance of the scar.  I prefer to use Dermabond Prineo for the first 2-3 weeks followed by Embrace scar therapy.  This typically results in a very favorable scar. There are however no guarantees, and sometimes unfavorable scarring will occur despite our best efforts. All plastic surgeons have had unfavorable scarring. The truth of the matter is that scarring is probably more patient-dependent than doctor-dependent, although surgical techniques and scar management certainly play a role. Best wishes to you!

Chad Douglas Tattini, MD · Answer

We usually recommend scar massage with Biocorneum starting around week 3. We also recommend sun screen starting then even when covered in sun environment. I also recommend night time taping of the scar for the first few months. Massage is recommended for a whole year.

Nirmal Nathan, MD · Answer

Every surgeon has a different approach for scar therapy after Tummy Tuck. Ultimately, the two most important factors will be how tight the closure was and your inherent scar tendencies.

I usually tape the scar for 2-3 months after surgery. Some patients decide to purchase Embrace, which is a special product that relieves tension off of the incision. I usually have them purchase is separately and start it 2 weeks after surgery.

Kenneth Hughes, MD · Answer

I advise my patients not to touch their incisions and keep them dry until the scabs come off which may take weeks.  Many patients use silicone sheeting or some variation on their scars after 4 to 6 weeks.  As scars mature over months to a year, the quality of the scar usually improves.  Kenneth Hughes, MD, Board Certified Plastic SurgeonLos Angeles, CA

Robert V. Mandraccia, MD · Answer

burn research has shown that pressure garments achieve very good results but be careful of too much pressure in the early postoperative period.Sunblocks are important too as well as massage with a lubricant such as baby oil,cocoa butter etc

Ali Mosharrafa, MD · Answer

The only scar product with clinically proven results is Embrace scar therapy.  I incorporate it into all my abdominoplasties.  You can find information on line.
Good luck.
Hope this helps.
Dr. Ali Mosharrafa

Steven Wallach, MD · Answer

I usually keep the incision taped or stars-stripped for about 6 weeks. Sometimes I recommend other topical after the tape is removed. Best to ask your surgeon his preference.