Abdominoplasty Scar Care 101

A good scar outcome after tummy tuck surgery is a big deal to most patients. Minimizing the scar as much as possible is vital as it is the only trace that will be left behind after you get a abdominoplasty. The results, good or bad, can stick with you forever. Luckily, there are steps you and your surgeon can take to make sure your tummy tuck scars heal as nicely as possible.

A good tummy tuck scar will be hard to see and easily hidden. As an expert in body contouring, Dr. Bernard Beldholm specializes in making your scars as minimal as possible. He makes every effort to try to get the scar as perfect as possible so that you have the beautiful tummy you always wanted. Once it is healed, you will forget it is there entirely.

Understanding scars

Tummy tuck scars are always going to be red initially. It can take time to heal the scars. Careful planning and aftercare can help your scars look better and heal nicely much faster. It can take six months to one year for most tummy tuck scars to fade substantially. During that time, your body makes collagen fibers to heal and close the wound. This process takes time.

Tummy tuck scars after one year usually turn into a pale white line. It often looks smoother than nearby skin if you look closely. A good tummy tuck scar will blend nicely with the skin around it.

Your age, health, predisposition to scar formation, and lifestyle factors like smoking, sun exposure, and nicotine use can affect the scar’s appearance. However, there are important steps you and your surgeon can take to prevent bad tummy tuck scars. These steps can help you avoid needing tummy tuck scar revision surgery.

Planning and hiding scars

Dr. Beldholm is an expert at scar placement. He will plan the incision carefully so that it sits in the underwear line. You want to avoid a scar that is too high. The goal is that it can be easily hidden in normal underwear, a bikini, or even low rise jeans. It is important to discuss scar placement before walking into surgery. You want to be sure that you and your surgeon are on the same page. If you have a favorite style of swimwear or underwear, you are welcome to bring those in.

A mini tummy tuck scar is smaller than a full tummy tuck or extended tummy tuck scar. Many types of abdominoplasty also have a scar near the belly button, but Dr. Bernard will hide the scar on the inside as much as possible so you don’t see it.

Scars tend to be red for up to a year, or even longer in some people. Older patients tend to lose the redness in the scar sooner. Either way, you want that initial red line and the eventual thin, pale scar that is left behind once it is healed to be hidden. That is why good scar placement is so important.

There is no such thing as a “scarless” surgery, despite what some plastic surgeons claim. What they mean is they will minimize the scar as much as possible.

Good scars start during surgery

No one can control the type of scars your body produces. They can sometimes be hard to predict. Most patients heal normally if the incision and closure are done well. However, some people are predisposed to scar problems such as hypertrophic scarring. Darker scars can be common in patients with tan or dark complexions. However, the skill of the surgeon has a big impact on how your tummy tuck scar will look.

Choosing sutures

It actually does matter which kind of sutures your surgeon uses. Dr. Beldholm uses absorbable stitches inside the wound where you will not see them. There are no outside stitches interfering with the scar that will leave marks behind. If you have ever seen the track marks that get left behind with regular non-absorbable stitches, those can make a less attractive scar. It is also wise to avoid clips as an incision closure. Metal clips sit on the wound and tend to leave unsightly clip marks.

Stitching the wound

How the surgeon closes the wound is important. A skilled plastic surgeon like Dr. Bernard knows the importance of a neat stitching job. The stitches should be as flat, smooth, seamless, and neat as possible.

You do not want an uneven wound because that is going to cause a problem with wound healing. The surgeon must close it properly. You do not want a little opening here and there because it can cause the scar to bunch up. That can sometimes result in a raised hypertrophic scar due to more scar tissue.

Another thing to look out for is having too much tension on the wound. That is why Dr. Beldholm uses the permanent stitch deeper down in the abdominal wall rather than near the wound surface because it is bad to have too much tension on the actual superficial wound. (The only reason he would not use them is if you are very unless thin because in thin patients, they can sometimes be felt through the wound.) Then he does another layer of stitching that lasts about 180 days. Finally, there is one more layer called a subcuticular stitch. This brings the closure together very nicely. His way creates a better scar.

Wound dressings

The wrong dressings can actually worsen a tummy tuck scar. Over the last five years, Dr. Bernard has noticed a significant improvement in scars by using a dressing by PICO. Before that, he used to use a little bit of glue and a dressing. That later progressed to Prineo, which is tape with glue on it. Over time, it became apparent that PICO seems to give much better tummy tuck scar results. That is what he continues to use today.

PICO is a suction dressing that brings blood to the wound for better healing. PICO works using battery packs that enable it to suction the wound and create a negative pressure that holds the wound together. It is important to note that at first, your incision may look dark, but that is just the Histoacryl glue that Dr Beldholm uses, not the wound itself. This glue will dissolve and fall off on its own in just a few weeks.

Glue helps seal the wound and prevent infection. It’s actually good to leave the glue intact as long as possible so there is no need to peel it. Glue helps take tension off the wound, which makes a better scar.

Aftercare tips and tummy tuck scar treatments

here are many things you can do to help improve the appearance of tummy tuck scars after surgery. Surgical scar remedies are a good idea if you are concerned about refining the scar as much as possible. There are medical treatments such as LED light therapy and Laser Genesis, but you can also try silicone sheeting to reduce the redness of the scar.

Keep it clean

The number one goal after surgery is to avoid getting the wound infected. This almost certainly results in a bad scar. An infection is going to break down the scar and hinder healing. More inflammation results from infections, and it can even result in more scar tissue. You want to avoid this.

Dr. Beldholm will cover the wounds with sterile dressings before you wake up from surgery, which is an important step toward avoiding infection. Avoid touching the wound straight after surgery. Even freshly-washed hands can harbor germs and bacteria that hand soap alone does not remove. Underneath the fingernails are also hard to clean, so you will find bacteria there, too. For this reason, you should avoid fussing with or picking at the scar once the dressings come off. Let it alone and allow nature to take its course.

Regular bathing and antibacterial soaps such as Dial soap can help as well. Early on, you want to let the soap gently suds on the wound, but avoid scrubbing, rubbing, or otherwise agitating the wound. Doctor Bernard will provide you with simple aftercare instructions so that you know exactly how to care for the wound once you go home.

Avoid sunning

Sun exposure can permanently change the scar’s color, making it darker and more obvious. The sun is responsible for hyperpigmentation in the skin.3 Freckles, age spots, and melasma are good examples of this. Scars are no different. The sun breaks down collagen and elastin in skin, which are key for proper wound healing.4

Keep scars out of the sun’s UV rays for at least one full year after tummy tuck surgery. Even if your incision is hidden in a bikini, you still should use SPF in case some of the UV rays penetrate the swimsuit. In strong Australian sun, it pays to be extra careful. You do not want to ruin your tummy tuck results by making the scar look worse thanks to a day at the beach. Even 15 minutes of strong sun may damage skin.

Once the scar is healed and begins blending in with your skin, it is still a good idea to reduce sun exposure. Avoiding a tan can help the scar blend in better once it is healed. The healed, white scars have a loss of pigment, so they won’t tan like the rest of your skin. Dr. Beldholm will make sure that your tummy tuck scars are hidden in your bikini line of your swimsuit or underwear, so that is an area that usually won’t see the sun anyway. But it is still something to be mindful of, especially if you use tanning beds.

LED light treatment

Medical lasers are great for treating scars. LED light is excellent for helping the wound heal attractively. LED light therapy for scars uses a specific wavelength that inhibits the inflammatory cells on the wound. This can help the scar look calmer and less red quicker than leaving it alone would. It also encourages blood flow and stem cell activation for better tissue repair and wound healing.1 Hypertrophic scars also benefit from treatment.

LED light treatment can take several sessions, and the results will come with time. There is no pain or downtime. It also does not damage the surrounding skin.

Silicone strips

Four weeks after surgery is the perfect time to start using silicone strips. Silicone strips have been used for surgical scar management for more than 30 years. Almost every plastic surgeon agrees that they make a better-looking scar. They work great on normal tummy tuck scars, and can even benefit patients with hypertrophic or keloid scars.2

Silicone strips are commonly used to improve the appearance of scars after surgery. They also help take tension off the scar as it heals.

Silicone sheets should be worn for about 8-12 hours a day, and you can even reuse the same strip the next day. Dr. Beldholm will provide you with these so you do not have to buy them on your own. However, tummy tuck scar treatments kits and silicone sheets are available online and at some drugstores.

Laser Genesis

Laser Genesis makes a huge improvement to scars. This laser reduces the blood vessels in the wound, which are what causes the scar to appear red. Redness is the thing that really stands out most after surgery, and most people want to get rid of it as quickly as possible. The redness in the wound usually takes up to 12 months to settle down, but for younger patients it can take even longer. Laser Genesis speeds this along so you can get the wound to look nice and pale so that it blends in with your skin quicker. It is a wonderful technology for tummy tuck patients wishing to reduce scars.

Beautiful tummy tuck scars are created

Good-looking tummy tuck scars result from careful planning that begins in the operating room. Be sure to discuss any scars with your surgeon to make sure you are on the same page with the placement. Even if you have not had a good scar outcome, there are treatments you can try such as LED light and Laser Genesis to make it look better. The earlier you treat the scars, the better. Scar revision surgery is also possible for patients who need it.

References:

1. Avci, Pinar, et al. “Low-Level Laser (Light) Therapy (LLLT) on Muscle Tissue: Performance, Fatigue and Repair Benefited by the Power of Light.” Semin Cutan Med Surgery, Mar. 2013, pp. 41–52., doi:10.1515/plm-2012-0032.
2. Bleasdale, Benjamin, et al. “The Use of Silicone Adhesives for Scar Reduction.” Advances in Wound Care, vol. 4, no. 7, 2015, pp. 422–430., doi:10.1089/wound.2015.0625.
3. Commander, Sarah, et al. “Update on Postsurgical Scar Management.” Seminars in Plastic Surgery, vol. 30, no. 03, 2016, pp. 122–128., doi:10.1055/s-0036-1584824.
4. Darvin, Maxim E., et al. “Influence of Sun Exposure on the Cutaneous Collagen/Elastin Fibers and Carotenoids: Negative Effects Can Be Reduced by Application of Sunscreen.” Journal of Biophotonics, vol. 7, no. 9, 2014, pp. 735–743., doi:10.1002/jbio.201300171.