What You Need to Know About Tummy Tuck Scarring
Every surgical procedure, whether for cosmetic or medical purposes, presents certain risks, including scarring. An abdominoplasty, a tummy tuck surgery, is one of Australia’s most popular cosmetic procedures. However, like every other surgical procedure, an abdominoplasty poses the risk of postsurgical scarring. The scars vary in size and location depending on the abdominoplasty procedure.
Scars can be uncomfortable. Therefore, the surgeon and patients should take steps to reduce and prevent bad scarring. They may involve considerable preparation beforehand and a rigorous recovery regimen afterwards. If you are considering an abdominoplasty, here’s what you need to know about tummy tuck scarring.
Disclaimer: Operation performed by Dr Bernard Beldholm. Adult content, surgery has risks; individual results vary, seek 2nd opinion. Please see the full disclaimer.
Scarring after Tummy Tuck (Abdominoplasty) Surgery
Scarring is inevitable after surgery. An abdominoplasty involves the removal of excess skin, tissue, and fat from around your belly. Such considerable reconstruction of the body’s contours is bound to leave a scar. Scarring after abdominoplasty is natural and is not a complication in its own right.
However, there are scenarios where an innocuous scar can evolve into a cause for concern. These are:
- Patients who have problems with wound healing
- Patients with a genetic predisposition for keloid or hypertrophic scarring
- Whether the patient experiences any postsurgical complications like infections
- The surgical technique and
- How well the patient followed the doctor’s postsurgical instructions
Bad scarring
Scarring after abdominoplasty is normal. However, there are instances when a patient develops irregular and excess scarring, which appears irregular, large, and reddish. There are several reasons that you may end up with a bad scar. Well, extra scarring often results from interference in the healing process, resulting in excess collagen, proteoglycans, elastin, and extracellular matrix proteins.
The common types of irregular/ excess scars include keloid and hypertrophic scars. So, let’s look at some common bad scar types that tummy tuck patients will likely experience.
Raised Scar
A raised scar is a scar that protrudes and can be felt above the skin. The scar can occur in different types and different degrees. Raised scars are visible and can be uncomfortable. Most of these scars on the skin’s surface are flat. On the other hand, raised scars occur when the body produces excess collagen to heal a deeper wound, especially on the dermis layer.
Hypertrophic Scar
This abnormal scar formation leads to a thick, raised scar. The verticle scar occurs mainly in areas with taut skin after a standard tummy tuck incision, burns, or any other skin trauma.
Keloid
Keloids are severe cases of hypertrophic scars. Unlike hypertrophic scars, keloid scars can spread beyond the original incision site. It occurs mainly on the shoulders, cheeks, middle chest, or earlobes.
A keloid scar can form after months or years following skin injury and grows for a long period. The scar is raised, smooth, shiny, hairless, and has a different colour compared to the skin around it. The scar feels painful or itchy when it’s growing.
Widened Scar
Widened scars are thin, flat, and a little more comprehensive. The scars widen in response to tension on the wound edges. Widened scars are common in body parts experiencing constant motion, like the shoulder, back, and knee. Widened scars can be camouflaged using makeup.
Hyper and Hypopigmented Scars
Hyperpigmented scars appear darker than the surrounding skin. They mainly occur due to increased melanin production. Hypopigmented scars, on the other hand, appear lighter than the surrounding skin and occur due to reduced melanin production, which makes them look pale and whitish.
Tethered Scars
The skin is made of a fat layer separating the dermis and the muscle. In some cases, the fat layer can be missing under the scar. Tethered scars occur when the scar gets attached to the muscle layer. This results in a scar that appears pulled and visible.
Tethered scars can occur during normal healing. However, they are more likely to occur if the body doesn’t repair the fat layer under the wound during recovery.
Tummy Tuck (Abdominoplasty) Scar Placement
There are various approaches to performing an abdominoplasty- based on the patient’s body and the amount of reconstruction in the abdomen region. Each variation of the abdominoplasty surgery results in its kind of scar.
Abdominoplasty scars will be around the pelvic area, belly button, or lower abdomen. A rule of thumb to keep in mind is that the more extensive the abdominal reconstruction, the larger and longer the surgery scars will be.
Types of Tummy Tuck (Abdominoplasty) Scars
During an abdominoplasty, the surgeon cuts an incision to remove excess fat and tissue. The excess skin is then pulled taut and trimmed away. A neat closing of the incision ends the procedure. The tummy tucks scar seen after abdominoplasties occurs when the surgeon closes the incision.
The scar’s appearance will depend on what kind of operation the patient has had. The different types of abdominoplasties and their scars are:
Mini Tummy Tuck (Abdominoplasty)
When just a tiny amount of loose skin needs to be removed, surgeons will perform a mini-abdominoplasty. This leaves just a small scar along the bikini line, which the clothing and underwear can conceal. The belly button remains in its original position since the surgeon removes only the excess loose abdominal skin. The mini tummy tuck scar is about the size of a C-section scar.
Full Tummy Tuck (Abdominoplasty)
The full abdominoplasty is also commonly called a “standard tummy tuck.” Most patients opting for a full abdominoplasty have lost considerable weight or just gone through pregnancy. Whatever the reason, they have significant amounts of loose skin and stretch marks. The surgery scar from a full tummy tuck is located on the bikini line, just above the pubic area, and spans from hip to hip.
Extended Tummy Tuck (Abdominoplasty)
The loose skin and problem areas are on the hips and the front of the abdomen. For these patients, the recommended procedure is an extended abdominoplasty. The scar is longer since the surgeon has to reach further around to reconstruct the abdomen. Extended abdominoplasties result in scars that extend beyond the hip bones and onto the patient’s flanks.
Fleur-de-Lis Tummy Tuck (Abdominoplasty)
When an individual undergoes weight loss surgery, or even in some cases of drastic weight reduction, there is loose skin all over the front of the belly. To correct this during a tummy tuck, surgeons perform a variation called a fleur-de-lis abdominoplasty. This operation is named after the shape of the scar it leaves, which runs horizontally from hip to hip and vertically up the front of the stomach.
Total Body Lift
The scope of an abdominoplasty sometimes extends beyond the stomach. A total body lift is also called a circumferential abdominoplasty. Apart from the stomach area, this surgery removes fat from a patient’s flanks, back, and upper thighs. A circumferential abdominoplasty results in a scar that runs the circumference of a patient’s waist, lower abdomen, and lower back, as inferred from its name.
Tummy Tuck (Abdominoplasty) Scarring Over Time
While your scar will never completely fade, its appearance does change over time. The scar becomes less visible and prominent as you recover from the surgery. Eventually, once the scar has fully healed, it should look much lighter and less noticeable than the immediate days after the surgery. How keenly you follow postoperative care also plays a crucial role in how your scar looks.
The scar healing timeline will vary from individual to individual, but most will follow a similar general pattern. Here is an approximate timeline of how abdominoplasty scars look as they mature.
- Post-Surgery: Right after the operation, abdominoplasty scars look thin and pink. This is because the body produces collagen to close the incision made by the surgeon.
- One Month: The scar starts getting darker, thicker, and more raised in the weeks after abdominoplasty surgery. It takes on this more noticeable appearance because your body supplies the wound site with blood and collagen to aid the scars heal.
- Six Months: After several months since the surgery, abdominoplasty scars start to lose the dark colouration. It might still seem reddish, but it will start becoming more pale. It will also flatten out as the incision heals and the collagen breaks down.
- One Year: About 12 months post-surgery, most scars reach full maturity. If the healing process has gone smoothly, the scar will be thin, flat, and light at this point. As more time passes, the verticle scar will fade and become less evident.
Minimising Scarring Before and After Surgery
Even though abdominoplasty scars are unavoidable, they can be managed and reduced with the right steps. Following preventive measures before and after the surgery can improve the results of your scarring.
Before Surgery
An abdominoplasty is major surgery. So, patients considering the procedure should ensure it is the right time for such an operation. For example, women expecting to get pregnant in the future or people who foresee massive weight loss should postpone the surgery. Having babies or losing weight can affect the aesthetic results of the procedure.
Another essential factor to consider before surgery is the patient’s lifestyle. Smoking can cause complications during surgery, so patients undergoing an abdominoplasty should quit smoking at least four weeks in advance.
Also, ensure you select a qualified specialist surgeon (FRACS behind their name). The surgeon plays a considerable role in the success of any surgical procedure.
After Surgery
After successfully performing an abdominoplasty, the plastic surgeons will give you postoperative care instructions. Following these is essential for wound healing without complications and ideal scar formation. Doctors tailor their postoperative care instructions on a case-by-case basis. But most will dispense some standard advice, such as:
- Stopping smoking (at least six weeks after the surgery)
- Avoiding medications with corticosteroids
- Maintaining a healthy diet, including Vitamin A supplements
- Keeping off the sun and applying sunscreen of at least SPF 30 on the scar
- Wearing loose, comfortable clothes
- Refraining from straining your abdomen through heavy physical exercise or sexual activity
- Wearing support garments
- Mosturising the skin and applying scar cream
- Dermapen or skin needling
Tummy Tuck (Abdominoplasty) Scar Treatments
Some tummy tuck patients remain unsatisfied with the appearance of their abdominoplasty scars, even after they have healed and matured naturally. Fortunately, some treatments allow you to reduce visible scars caused by the tummy tuck procedure. The most common tummy tuck (abdominoplasty) scar treatment options include:
Laser Treatment
Laser treatment, also called laser resurfacing, uses vascular lasers to resurface the skin. The lasers collapse the blood vessels on the skin’s surface, reducing the redness and replacing scarred skin with healthy collagen. This treatment improves the colour and texture of abdominoplasty scars. However, it is expensive and could require multiple sessions.
Intralesional steroid injections
Intralesional steroid injections help get rid of excess scarring. It involves injecting corticosteroids like triamcinolone acetonide immediately below the skin or directly onto the lesion. The surgeon can apply the treatment during the surgery for prevention or after around four weeks for correction. Treatment costs depend on the severity and size of the scar.
Punch Grafts
During punch grafting, the surgeon makes a small hole in the skin and removes the scar tissue. The surgeon then replaces it with skin from another body part, commonly the skin behind the ear, and places sutures to hold the skin in place. The scar remains but becomes smoother and less visible.
Scar Revision Surgery
Some patients turn to plastic surgery once again. Scar revision surgery is a good way to make an abdominoplasty scar appear less noticeable. It is a minor surgery that makes any scars less visible. However, waiting for your abdominoplasty scar to mature (at least a year) before going in for scar revision surgery is advisable.
Silicone Sheets
Silicone sheets involve using self-adhesive medical silicone sheets to treat abnormal scarring. The silicone sheet acts as the skin’s protective layer, helping the skin retain and maintain moisture balance. This helps in hydration, increases scar healing, and reduces scar visibility and other scar-related complications.
Frequently Asked Questions
There are several questions that people ask regarding tummy tuck scaring. Here are a few of them.
How bad is the scarring after a tummy tuck?
Scarring after a tummy tuck surgery is inevitable. Every abdominoplasty results in a scar. However, the shape of the scar depends on the kind of procedure; each procedure creates a different-looking scar. Wound healing and scar fading depend on factors like lifestyle habits, age, and genetic predisposition, which also play a role in determining an abdominoplasty scar’s appearance.
What is the progression of a tummy tuck scar?
A tummy tuck scar changes appearance over time. An abdominoplasty scar normally takes over a year to mature fully. At first, it will look thin and pink immediately after the surgery. Then, the wound starts to heal, becoming darker, thicker, and more raised. Eventually, as the healing process continues, the collagen at the wound site breaks down, and the scar becomes paler and less visible over time.
What is the best way to hide a tummy tuck scar?
A standard or mini abdominoplasty usually results in a thin scar from hip to hip on the bikini line. These scars are concealed under clothing and underwear. Some people decide to get tattoos that cover their tummy tuck scars. Another way to reduce an abdominoplasty scar is by applying topical treatments.
Will my tummy tuck scar drop?
It’s possible for your abdominoplasty scar to shift downward, or “drop,” in the weeks or months following your surgery. This happens as the swelling surrounding the incision goes down, and your skin settles into place under its newfound tension. Your surgeon can estimate this downward shift during the consultation and place the incision accordingly. Patients in for an abdominoplasty should expect their scars to shift slightly as they heal.
Bottom Line
Scarring after a tummy tuck (abdominoplasty) procedure is common. However, in some instances, the procedure may result in excess scarring requiring additional attention. Therefore you should consult a qualified surgeon before undergoing abdominoplasty and strive to reduce scarring.
References
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