Your scar is not a keloid it's a hypertrophic scar. It is to be expected in people of color. But I have also seen the same results in the same location with white patients.
The most important issue is not to over treat. Do not excise the scar, the risk of recurrence is high.
II do not recommend radiation, it's expensive and does not always work. An injection with small doses of kenalog over a long period of time is usually a much better treatment .
but that treatment must be done slowly as it has it own complication of destroying the subcutaneous tissue.
Also consider the use of silicone sheets.
as always, speak to your surgeon.
You might want to consider silicone gel strips or even steroid injections. However, the steroids may cause the skin to lighten.
eryag fractional laser with triamcinolone cream.
do not have scar incision, do not get radiation
the latest tx is erb yag laser and triamcinolone and 5fu
tape scar at all times
Your scar is wide, but depending on exactly what it is (keloid vs hypertrophic scar), the therapy can be very different. For keloids, often we can cut out the old scar and start with series of steroid injections. If that fails, then I typically get radiation involved. I would get a pathologic diagnosis of this first though- steroids can make hypertrophic scarring worse and radiation is rarely used. My advice is to pick a small segment of the scar, cut it out, re-close with as little tension as possible, inject with steroid, and watch and wait. In the meantime, you will get pathology back on your scar and they can tell you exactly what's going on.
What you have is a hypertrophic scar, not a true keloid. There is only one product that has Level 1 human data demonstrating a reduction in scarring. It is a dressing called embrace made by a company out of Stanford called NeoDyne. The scar needs to be surgically revised. Then, the dressing is applied 1-2 weeks after surgery and changed weekly for a total of 8 weeks of therapy. I am confident that this will improve the appearance of your scar.
You may want to look into brachytherapy where they run a catheter specifically in the scar area to deliver localized radiation after excision. Perhaps a better option than beam radiation in terms of reducing your overal radiation exposure.
I hope this was helpful,
Dr. Daniel Barrett
Plastic and Reconstructive Surgery
Beverly Hills, CA
Sorry to see that you are having difficulty. I agree with the previous authors. This is an unfortunate sequelae of your body composition and not a complication nor reflection of the caliber of your surgery/surgeon. Furthermore, it may happen again with addition surgery. Nevertheless, of the remedies mentioned, the one most likely to benefit you, at this point, is Embrace. However, to be most efficacious, Embrace is applied two weeks post op. In other words, you must have the incision re-excised and then begin treatment at approximately two weeks later. Kenolog may cause the scar to flatten but it will still be wide. And it may develop unsightly prominent vessels in the scar as well (called telangiectasias). Silicone strips and dressing are slow, cumbersome, and will once again yield a flattened, wide scar. ALL of the treatments require your complete compliance with the regimen. In order to be effective, you cannot opt out because of the treatments inconvenience or because it doesn't mesh with your outfit.
Having said this, I do believe that it is a worthwhile undertaking. You may also consider extending the treatment to your belly button. Good luck and please send follow up photos.
It looks like you have more of a hypertrophic scar than a true keloid. I would recommend massage, silicone scar gel and/or sheeting, and kenalog steroid injections as a first step. Fractional erbium lasering can also be helpful in flattening the scar. I would not consider revision surgically until trying these other remedies.
From the photograph it is clear you did not have a keloid. The scar is still thickened because of what appears to be ongoing healing. My advice is for the time being is to leave it alone.
There are many approaches to dealing with hypertrophic scars. After a tummy tuck, I have my patients tape the wound for six weeks. This has been shown to improve the appearance of scars in some people. If there is some question of whether more attention is needed after this point, I have the patient's apply silicone sheeting. If this is not satisfactory after 3 to 6 months, either steroid injections into the scars or excision with radiation can be tried.