Also known as abdominoplasty, a tummy tuck is a procedure that removes excess fat and skin from the abdomen. Often combined with liposuction and “muscle tightening”, tummy tucks can result in a leaner, smoother, and slimmer belly!
And this is why it is one of the most popular cosmetic surgical procedures in the US. There were 140,711 tummy tucks performed in 2019 and has been increasing over the years.
Probably one of the most common questions about abdominoplasty is how the scars will look? In this post, we’re going to discuss tummy tuck scars and what to expect after this procedure.
DISCLAIMER: This information is meant as general health information and is not meant as specific medical advice or as a replacement for direct communication with your plastic surgeon.
Regardless of the type of abdominoplasty (mini vs full tummy tuck), scars will need to be created. When skin is cut away, an incision is made, and a scar will result. The final length, position and quality of these scars will depend on several factors. We will discuss a few here.
Most abdominoplasty procedures leave a scar running horizontally across the lower abdomen, usually lower than “normal” modern waistbands. The goal is for the scar to be at the junction of the abdomen and the lower hair-bearing pubic area (mons pubis). The shape of the scar depends on the type of tummy tuck surgery (straight line, bicycle handle or French bikini).
Most full abdominoplasty procedures will place a scar around the bellybutton. Your native belly button stays in place, and the skin of the abdomen ‘moves around it’. Although the scar maybe visible at first, for most patients it will blend into the abdomen and becomes less noticeable over time.
Even though most tummy tuck scars are only horizontal, a vertical scar may also be needed.
Some patients may heal with abnormal scars, but this is uncommon. These scars form due to excess of collagen, and include:
Some patients may heal with wide scars that are not “abnormal”. Although this can occur in ANY patient, there are certain risk factors for wide scar. The most common contributor is Excess Tension at closure, and is due to trying to remove too much skin during the tummy tuck (sitting the patient up too much during skin removal). As an aside, this is also one of the reasons the scar may rise upward more than it should. Postoperative recovery also affects scar width. We recommend scar tape to reinforce and support the healing scar when it is still weak and prone to widening.
Many factors that influence scar healing are specific to each patient. These include age, nutrition, genetics, compliance(or noncompliance) with postoperative care instructions, smoking, infection, tension, size, activities, and overall body composition. Your general health and wellbeing clearly play a role in how fast and how well your scars heal and fade. Below you can see the general description of the healing process of tummy tuck scars indifferent stages.
The incision usually looks red and thin. There may be ridges or pleats in the skin. Swelling, inflammation, and a bit of oozing are the norm at this stage. Nowadays, most incisions will be reinforced with either tape or glue, and you may not be able to see your incision.
On a microscopic level, your cells are trying to hold the wound together, and will produce a more disorganized collagen network to help bridge the wound. Although quick to produce, this collagen is not as strong as final mature scar.
Wound healing is dynamic and actively changes over time. The initial disorganized collagen (think about it as the old pick-up sticks game) will be broken down and replaced with more organized ‘braids’ of collagen. This collagen is stronger but takes time to produce. Concurrently, during this period of turnover your internal stitches will be weakening and unable to provide as much support to the incision. This is where external support like tape can be helpful and why we recommend patients use it AT LEAST until 2 months after surgery. Longer is better.
Visually the scar will still be fairly dark and may be reddish in color (due to blood supply in the wound). Usually, the incision will flatten and small pleats may go away. You may still have a slight prominence (or a large dog ear), at the end of the incision during this time. If it is small, it will usually contract and soften becoming less noticeable by the time the scar is “mature”around 8-12 months after surgery.
It’s perfectly natural to notice scars are still visible even six months of the postoperative period. At this point, the scars gradually lose their pigmentation. This means there won’t be prominent red color, and you can see the scar fade. Instead, your scar may appear rosy pink or soft brown.
Scars take 8-12 months to mature. The scar is breaking down blood vessels it needed to help heal the wound, and this is when scars tend to fade. The swelling is completely gone, and scars have faded considerably.
Scars after a tummy tuck are inevitable. Although the scars don't go away entirely, they typically fade overtime. However, there are some useful things you can do to make scars less visible. These include:
· Adhere to your plastic surgeon’s postoperative instructions – Your plastic surgeon should have a protocol for wound and scar care. Adhere to these recommendations is one of your best bets for getting the best scar possible.
· External scar support – help your scar while it is maturing by providing additional support.
· Well balanced diet with protein supplementation.
· Tattoo –probably the easiest way to make scars less visible is to get a tattoo, but you will be able to do this once your skin has fully healed (after 12 months).
· No tanning –UV exposure may cause your scars to maintain more pigment and therefore be darker in color. Avoid tanning your scars (i.e. make sure they are covered by bikini bottom, and sun screen around the belly button).
· Avoid irritating tape, clothes and products – products with harsh formulas and clothes made of uncomfortable and irritating fabrics can cause redness and make the scars appear prominent.
· A healthy lifestyle – the best thing to do in the long-run is to make lifestyle changes. For example, you can quit smoking and try to keep weight in a healthy range.
There are MANY reasons why this may be happening, only a few of which you will be able to influence directly. The most important advice is to COMMUNICATE with YOUR SURGEON! You both will need to work together to trouble-shoot the problem and identify and implement the changes that may help you heal faster and better.
THIS IS WHY YOU SHOULD CHOOSE A SURGEON WITH WHOM YOU CAN EASILY COMMUNICATE!!!! If you never meet your surgeon before surgery, or only see them for 5 minutes during a rushed consultation, then you can bet that getting face time with him/herAFTER surgery may be impossible. Choose your board-certified plastic surgeon wisely and avoid cosmetic tourism!
The tummy tuck is a popular plastic surgery procedure for a REASON! People choose to get a slimmer profile, look better in and out of a bathing suit, and feel more confident. Scars are NORMAL after this procedure, and most patients who undergo a tummy tuck are very happy with the outcome and would do the surgery AGAIN! Don’t let scars (which are usually easily concealed under normal clothing styles), hold you back from getting the benefits of a Tummy Tuck!