The first 4 weeks are surgery is the most critical time that you can impact the quality of your scar. During that time you want to support with a compression binder 24/7 and use silicone on your incisions (gel sheets or liquid). Your incisions are not strong until you are a month out so no physical exertion, sex or friction/massage should occur. That being said you can go for strolls and move about - functional but not active is how I often put it. Bed rest is in no way advocated..in fact that would be considered dangerous for your health. Scars remodel and improve for a year but if you are careful during this early critical period it will set the stage well. Your plastic surgeon will help guide you.
Reducing the scar after a tummy tuck
There are three key events that influence the scar. Number one, your surgeon, their technique and the steps they take to minimize tension and perform a beautiful closure. Things that you can do such as scar massage and tape and silicone. And finally genetics which is not something anyone can control. You don't want to overstretch the skin (think upward dog position), but sitting and moving around is not a problem. Furthermore, early movement is important for preventing blood clots and pneumonia. So find a great surgeon that really cares. Do the taping, massage and silicone. Choose your parents wisely.Dr Rodger Shortt
Would these steps reduce a scar after tummy tuck
Although your suggestions may help a small amount, what determines the quality of the scar will be the tension that exists at the time of wound closure. Avoiding things that will stretch the scar out after surgery are certainly advisable. I will say that getting up and moving around is crucial after surgery to avoid a blood clot in your legs.
Tummy Tuck Scar Management Concerns
Thank you for your question. While tension is a contributing factor to tummy tuck scarring, it is a multifactorial problem including your own inherent biology and ability to heal. Limiting tension related activities right after surgery is helpful to prevent wound separation, but after about 6 weeks, most surgeons recommend return to normal acitivities. While intuitively it may seem like more is better, this is not necessarily the care. Restricting activities for up to 12 weeks may be impractical and there is no evidence of an impact on scar quality. A more practical approach to scar management would be to use a tension reducing silicone device like Embrace. Compression silicone bands like Gel Zone are another alternative. You can continue this treatment for as long as you want without negative effects and there is some evidence of benefits in terms of scar quality. Hope that helps! All the best.
In my practice we use the Embrace scar therapy treatment. It encompasses all three proven factors for improving the look of scars; releasing tension, silicone gel, and an occlusive bandage. you can apply the treatment sheets as early as two weeks after your procedure, under your compression garment, and while showering. I hope this helps and I wish you a great recovery!
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.
Scarring after a tummy tuck
You are correct that reducing tension on your healing incision can potentially improve your scarring. However it is doubtful that avoiding the activities you describe will affect it that much. The best way to reduce tension on the incision is to use Embrace scar treatment. These are silicone dressings that you wear for the first 4-6 weeks which reduce the tension on the incision as it heals. Ask your surgeon if Embrace is available in their practice. Best wishes to you!
Your questions are very intelligent, but they do not take into consideration patient factors beyond your control. Some patients scar well without taking any of the precautions you mentioned, and some do not despite all our efforts. The newer quilting procedures (aka drainless tummy tucks) seem to give the patient a better score . See a board-certified plastic surgeon Who does a ton of tummy tucks and you will be in good hands.
Reducing the prominence of a tummy tuck scar.
Good question. Reducing the risk of wound breakdown and avoidance of stretching or physical exertion are helpful but scar formation is a process that lasts for months. Final "maturation" of TT scars occurs around 9-15 months after surgery so we need to find practical treatments as well. One device that I find very useful and probably much better than silicone gel (though more expensive) is application of Embrace Scar Therapy (look it up on Youtube) beginning at about weeks 3-4 post TT. The tension reducing tapes are changed every ten days for approximately 60 days and the scars are noticeably reduced (though not eliminated) for most all people. I've only seen a couple who didn't tolerate the treatment due to irritation.You might discuss this option with your plastic surgeon to get his/her take on the benefits. Good luck and best wishes.Jon A. Perlman, M.D. FACS
Certified, American Board of Plastic Surgery
Member, American Society for Aesthetic Plastic Surgery (ASAPS)
Beverly Hils, Ca.
Dear Dars, The most important factor in determining you quality of scar is your genetic make up. Thin skin is usually associated with nice healing scar. Other factors that have negative impact on the scar healing process are tension, infection and hematoma, so, anything that eliminate those factors will improve the quality of scar. In my practice I do not recommend to stay in bed , because of the risk of developing dangerous blood clots. Here are my ways to reduce bad scar:1. Oral antibiotics 2. wash hands when handling wound, 3. Velcro abdominal binder for 3 weeks or longer , if you feel comfortable wearing it. 4. avoid any physical activity for 3 weeks and intense physical activity for 6 weeks 5. Close follow ups with your surgeon. 6. walking is allowed as long as it is slow pace. 7. desk work allowed after 4-7 days. 8. cooking and light dusting is allowed after 3-4 days. 9. skin bleachers to reduce darkness .10 coco butter, shay butter, vit E , Mederma are helpful for scar maturation and good healing. 11. Kenalog injection for scar hypertrophy. I hope this helps. Best of luck, Dr Widder