Tummy Tuck Scars | Compression Garments, Creams, & more Treatment Tips

Many women who have been pregnant once or more, who had a c-section (cesarean section), or who have lost a lot of weight are left with loose skin in the lower belly area. Not only wrinkled skin on the stomach but also old scars from e.g. other surgery such as a cesarean delivery can be removed. Also the removal of excessive fat or the tightening of abdominal muscles are reasons to undergo a tummy tuck procedure.

The common goal is to create a more tight abdominal area, a slimmer waist line and to improve overall body shape. These aesthetic improvements of the tummy can take away self-consciousness and boost self esteem and confidence.

Photo by Haabet | Wikimedia Commons

The type of abdominoplasty procedure determines which incisions will be made and subsequently the amount of scarring.

If the purpose is to only some mild sculpting of the tummy a mini tummy tuck will suffice. When there are other objectives such as the removal of fat and loose skin and tightening muscles, a more invasive procedure such as the extended tummy tuck will be implemented.

The complete tummy tuck is the most common abdominoplasty procedure. The first and largest Incision is a partly horizontal straight line across the abdominal area between the hips going up to the hip bones. The location of the middle of the scar is just above the pubic bone. The second standard incision is a circular shaped cut around the naval. This belly button scar is called umbilicus. Commonly some other minor additional incisions are necessary.

The mini tummy tuck procedure is also referred to as the partial or scarless tummy tuck. The term scarless is deceptive because incisions have to be made so scars will develop. But with the use of special techniques size and visibility of scars are reduced. Other names are low tummy tuck because there is no need to readjust the naval and the only incision will be made on the lowest part of the abdominal area.

The incision made, and thus the scar, depends on the amount of skin that has to be removed. Because this is a less invasive procedure this horizontal scar will be smaller than that of the traditional operation. Also will there be no naval scar.

circumferential

This is the least invasive tummy tuck procedure with minimal scarring which is only suitable for women who don't need to have loose skin removed. Thanks to the use of specialized instruments the surgeon is able to only make several small incisions in order to perform the desired goal.

It is common for patients to have to deal with wound pain, bruising, and swelling. Whenever someone experiences more severe complaints such as bleeding, infections and necrosis (black, dead tissue) action must be undertaken because these conditions slow down the healing process. It is always strongly recommended to do so in close dialog with the concerning surgeon or dermatologist.

Tummy tuck scars are known to get worse before they improve. In contrary to many other surgical scars they will be roughly at their worst in about 3 months after the procedure. Only after a year they will be reaching the final phase. Before that time they will appear raised and red or purple. Eventually they will become softer, flat and tone in. In most cases that is.

Besides scars also bruises and swellings will most like appear after the procedure. As with all surgical scars it is recommended to start treating them as soon as possible. This will lead to an optimal final result. The first thing to accomplish is to make sure the wounds heal optimally. Infections and inflammation should be avoided because they tend to worsen scar appearance.

Things to consider in the wound healing phase are keeping the tape on as long as possible. The tape's pressure keeps minimizes tension on the wound. Also asking your surgeon or dermatologist about medical honey dressings might be a good idea. These are scientifically proven to reduce hypertrophic scarring.

After a surgical procedure such as the tummy tuck commonly three types of scars will occur; 1.normal, non-problematic scars, 2.hypertrophic scars and 3.keloid scars.

Non-problematic scars require no treatment. But whether or not someone develops problematic scars is not something one knows up front. Many wounds, especially surgical wounds, turn into hypertrophic or keloid scars. That's why prevention is recommended.

Directly after the wound has healed treatment of the scar can be started. The most convincing evidence for an effective scar therapy is that for silicone dressings.

Also hydration and occlusion (which will be accomplished by using dressings) seem to help realize the best scar appearance one can get. Studies have shown this multiple times.

In my opinion one of the best, if not the best, silicone strips brand is ScarAway. Their silicone scar management sheets are self-adhesive and are manufactured with the patented Silon technology.

Differences between brands are not only the amount of active silicones present in the product but even more important the type of silicones. The best silicone is the so called dimethicone. Other brands do not make use of this type of silicone but

Here's a review of someone asking if people have experience with silicone strips for tummy tuck scars:

"Just 10 days out from my tummy tuck and starting to research scar removal creams and silicone sheet strips. Anyone have any experience with any products? I'm looking at Biodermis and Scar FX the silcone strips since they seem to stay "on" for weeks. Sounds better than a cream which I have to apply a few times a day. Anyone have experience? They are so costly I wanted to see if anyone had any opinions as I can't find any non-add on the web."

"I didn't use any, though I wish I had after my tummy tuck and subsequent revisions. I have heard that silicone sheets and Mederma are good."

"I had surgery for a hernitaed disk in my neck. The incision was made at the front of my neck. I used the silicone strips and had great success with them and the scar is pretty much invisible. I tried bioderm and maderma and neither compare to the strips. Use as recommended and i think you will be happy with your results~Good Luck!"

from skincaretalkforum.com

and another review:

"I used silicone patches from Scaraway for my tummytuck scar and am unbelievably content. My sisters scar got red and bumpy but mine healed flat and pretty thin and is regular skin color now... They stick to your skin without the need for tape but they are not sticky like bandaids. Hard to explain.. I hardly noticed wearing them...hope that helps"

Wearing an abdominal garment is a crucial part in the after surgery healing process. The tummy tuck garment is designed to apply the exactly needed amount of pressure to the surgical areas. This takes the tension off of the wound thus stimulating the wound healing process.

These garments, also referred to as abdominal binders, apply pressure to the swollen areas, improve draining of toxic fluids, and help the skin conform to its new contours. The pressure applied by garments also stimulates blood circulation which is an important factor in scar healing. The faster the wound heals and the less complications such as infections and inflammation occur, the better the final scar appearance will be.

The compression garment also reduces swelling and bruises by keeping everything in place. This store offers an extensive amount of medical grade garments.

"My doctor really stressed wearing the compression garment to get the best results. He said some doctors don't do it but it really helps with getting the good shape. I wore it even longer I think than was required - besides it felt better. (I was really sore for a week I think - but I'm a wimp when it comes to pain). So, that would be my most important advice - wear that compression belt constantly. I was very happy with my results. By the way, I didn't get any of those lumps people have been talking about - I was wondering if that is only from smart lipo - or if it happens from lipo only. Good luck!" source: plasmetic.com

A study published in the European Journal of Medical Research in 2003 discovered that manuka honey - when compared with conventional treatments for infected postoperative Caesarean sections and hysterectomy wounds - had an 85% success rate compared with 50% for routine treatments.

It might be useful to ask your surgeon or dermatologist about manuka honey wound dressings. These FDA approved medical devices have shown to speed wound healing, help prevent infections, effectively treat infections, and minimize scarring.

This depends on the type of operation someone has undergone. The scarless, mini, low or partial tummy tuck only requires an (often strategical placed) incision below the waistline on the part where the bikini or underwear will cover it from view.The largest of the traditional procedure is also lower then where a two piece bikini would show. Tummy tuck scars are usually positioned below the waistline where bathing suits cover the scar.

It is important to avoid sunshine as much as possible on immature scars. Up to about 1,5 years after the procedure suncream with at least SPF 15 should be applied. Also underneath thin clothing such as cotton t-shirts.

Also make sure not to overstretch the scar tissue as long as the scar is fresh (immature). Stress on the scar by vigorously exercising or sudden movements can result in wider, more prominent scarring.

Scar massage can enhance the healing process and scar appearance but should always be started only if the wound has been healed and when it is allowed to remove the compression garment. It can help diminish swellings and bruises as well. Always consult your surgeon or dermatologist for instructions and permission to start with massage. The massage can make the tissue more supple and dissolve adhesions and bumps.

"Massage helps break down the dense bands of collagen that attach to underlying tissue, a common reaction to cesarean sections, appendectomies or hand wounds,,"
source: Robert Bernard, M.D., a plastic surgeon based in White Plains, New York, and president-elect of the American Society for Aesthetic Plastic Surgery.

Lymphatic massage is especially useful for tummy tuck patients. It reduces swelling and bruises, decreases the chance on developing problematic scar tissue and stimulates the immune system. It works by boosting blood circulation and moving pooled fluids.

It needs to go very slowly when you are first recovering from surgery. Very gentle massage in circular movements can later on be expanded to more frequent massage. Start out with about 30 seconds a few times a day. Although it is not intrinsically necessary I preferred to use oil or cream to massage my scars. This because it felt better since my scars were rather sensitive. (this seems to depend on the person and location on the body) Also hydration is a major scar improving factor which is why using a moisturizing oil or cream might be helpful.

Smokers are at increased risk for complications. This is why patients are motivated to quit smoking. In some cases, when patients are unwilling or unable to quit, the surgery will not be performed.

Also after the procedure it is strongly recommended to quit smoking because it involves a significant higher risk on developing more prominent (problematic) scars. The longer someone is able to stay away from cigarettes the better this is for the final scar appearance.

It depends on the surgeon which type of wound closure they utilize. Some surgeons say they prefer sutures (stitches) over staples because these provide a more rewarding aesthetic result. Staples seem to have the benefit of fast wound closure. Another option is skin closure by 'tissue adhesives'.

This study shows surgical wounds closed with sutures compared to those with adhesives resulted in the same scar appearance. Significant difference was the time it took the surgeon to close the wounds. The adhesives allowed for a much faster closure.

This study report shows: "It is unclear whether tissue adhesives are more or less effective for closing surgical incisions than stitches or adhesive tape."

Progressive tension sutures have shown to reduce the risk on local complications after the tummy tuck procedure. Common complications are skin flap necrosis, seroma and hematoma formation, and hypertrophic scarring. Apart from the very low complication rate there is also no need for suction drains. More on: progressive tension sutures. (.pdf file)

The tummy tuck procedure where no drains are used is referred to as progressive tension sutures. The sutures are placed inside, which distribute the tension instead of placing it all at the edge. This is said to result in less scarring. Opinions by experts differ though. Here are the visions of two plastic surgeons: RealSelf

Dog ears are excess skin or bulging tissue on one or both sides of the scar left after the tummy tuck procedure. Some cosmetic surgeons estimate that about 20% of the patients develops dog ears to a certain extent. In some cases they will flatten or disappear after a while. In other cases a small 'touch up' correction can solve this cosmetic problem. A minor, 10 minute, operation under local anesthetic will help you get rid of the dog ears.