Abdominal Scar Following Tummy Tuck

A scar is part of removing skin

An abdominal scar following tummy tuck surgery is expected, because the operation removes skin and that removal needs an incision. Any excisional operation leaves an incision line. The aim is for that line to heal as well as it can, and for the healed line to sit where clothing can hide it. A board-certified surgeon does not avoid the scar by skipping the incision. The scar is the incision after it heals.

A tummy tuck can change the abdomen after weight loss or pregnancy by removing extra skin and fat. Muscle tightening can be part of the same operation. Liposuction can be added when fat is treated along with the skin. How the scar heals is one of the things people use to judge the result. A poorly stitched or poorly healed line can spoil an otherwise lean abdomen and waistline.

Skin removal is the step that creates the line. More redundant skin can be taken, and the stomach contour is tighter when more skin is taken. That gain has a cost. The amount of skin removed is tied to how tight the closure is, and a tighter closure makes a more aggressive scar. Sutures and surgical technique matter too. Some of the result depends on how the person heals, which is not chosen in the operating room. Some of it depends on choices that are: the closure, the garment, and the way the person sits while the line is new.

Healing capacity is the part that comes with the patient. Two people closed the same way can still scar differently. Everything else is extrinsic. Suture choice and closure technique are set in the operating room. How much skin is removed is set there too, and that amount sets the tension on the line. After surgery, a semiflexed posture and the compression garment are the parts the patient can do. Both support a closure that was made tight on purpose.

Where an abdominal scar following tummy tuck sits

The usual line is horizontal, across the lower abdomen, placed so underwear and swimwear can cover it. A full abdominoplasty also leaves a scar around the belly button, planned to blend with the navel. A vertical scar is sometimes added. Its length and its place depend on the skin and on what the operation has to remove. The horizontal line, the navel line, and a vertical line are different scars, and a given operation may not include all three.

Planning the abdominal incision is what puts the horizontal line low enough to hide. Patients who are comparing offices can start from the tummy tuck locations. The line is still there after it is hidden. Camouflage is clothing and placement. It is not the absence of a scar.

The horizontal scar has to be long enough for the extra skin to come out, and low enough that underwear and swimwear cover it. The scar around the belly button belongs to a full abdominoplasty, because the navel is brought through a new opening and that opening has to heal. A vertical scar appears when the horizontal line alone does not solve the skin. Its length follows the skin and the operation, not one preset measurement.

How the line changes

A typical abdominal scar following tummy tuck keeps changing through the first 6 months. In the days after surgery the incision looks red and thin. Swelling, inflammation, and a little oozing are common. Collagen forms a network across the wound and holds the edges together.

As weeks become months, that collagen is reorganized into a stronger, more orderly repair. The scar can look dark at first. With time it starts to flatten and fade. Care during this stretch changes how noticeable the final line is.

Around 6 months the scar starts to lose pigment, moving from a strong red toward rosy pink or soft brown. By a year the scar has matured. The swelling is gone, and the line has faded enough to blend with the nearby skin.

The photographs show an abdominal scar following tummy tuck at 3 months. Three months is in the middle of that course, after the early red incision and before the year of maturation. The 3 month pictures are not the finished color of the line.

Early on, the line is a fresh incision. Red, thin, swollen, and slightly moist is the usual look while collagen bridges the edges. Later months are when that bridge is rebuilt. Disorganized collagen is replaced by a more structured sheet, and a dark, firm line can flatten and lighten. The scar at one year is the mature one: swelling gone, color faded toward the surrounding skin. Three months is still the rebuilding stage.

What the patient does while it heals

Staying semiflexed, and wearing the compression garment, both support an incision that heals in good position. High-definition body contouring instructions cover that posture and that garment. Patients are also seen in the days and weeks after surgery so the incision can be checked while it is still new.

Silicone tape and silicone gel sit on the line. They are topical. IPL is a light treatment that may be considered. A steroid injection may be considered when a scar stays raised and is not flattening. Massage and laser treatment sit in that same group. They are chosen for the scar the surgeon is looking at. Sun protection continues while the color is still changing, because ultraviolet light darkens a scar that has not matured. Silicone gel sheets are the sheet form of the same silicone care. Visits in the days and weeks after surgery look at the incision while it is new: whether the edges stay closed and whether the tension still looks acceptable. A later visit, around 6 months, is about color. The line should be leaving its strong red. Around a year, swelling should be gone and the scar should have faded toward the nearby skin.

Food plays a part in wound healing. Protein, vitamins, and minerals help, and vitamin C and zinc are the nutrients called out for this repair. Sun on a new scar darkens it. The line should stay covered in peak sun, and a broad-spectrum sunscreen helps when the skin is exposed. Smoking impairs healing and can leave a more obvious scar. A stable weight supports the same healing. The American Society of Plastic Surgeons describes a tummy tuck as removal of excess skin and fat, with tightening of the abdominal wall, which is the operation that leaves this line.

When the scar is not flat

An abdominal scar following tummy tuck can heal as a usual flat line, as a hypertrophic scar, or as a keloid. A hypertrophic scar is raised and red, and it does not keep growing. A keloid extends past the original wound. MedlinePlus reviews scars, including scars that stay raised. A scar that thickens or spreads is a reason to see the surgeon rather than to wait out the year.

A raised red scar that stays inside the original wound is the hypertrophic pattern. It can feel firm, and it does not march outward. A keloid is the scar that grows past the wound. Most lines do neither. They start red and thin, look darker and then flatter over the months, lose pigment after 6 months, and are mature around a year. Silicone, massage, light treatment, or a steroid injection is considered when a line leaves that course. The choice is made at a visit, from the scar that is actually present.