Published by Dr MIguel Fernadez Calderón: 08/12/2023
Abdominoplasty is one of our favorite surgeries. Its results are impressive and transform the patient's body. Unfortunately, to achieve this beautiful change we need to create a scar that allows us to remove the sagging skin of the abdomen and repair its musculature. Many patients are concerned about this scar. In this article we answer frequently asked questions about the abdominoplasty scar.. We also advise you on what you (and we as surgeons) can do to conceal it as much as possible.
What does a tummy tuck scar look like?
The scar of an abdominoplasty varies greatly depending on each specific surgery. Most commonly it is located a few centimeters above the pubis. Also, it extends horizontally along the front of the abdomen (from one iliac spine to another).
However, in people with a lot of skin flaccidity, the scar of an abdominoplasty should be longer. In other words, it is lengthened horizontally to where there is excess skin.
In patients with less flaccidity, a small vertical abdominoplasty scar may need to be added to the horizontal abdominoplasty scar. Fortunately, this is a small, fine line.
Occasionally, there are individuals with localized skin laxity only below the umbilicus, and no alterations in the musculature. These can benefit from a very short horizontal scar. This is known as "mini-abdominoplasty".
Anecdotally, we see patients with much more excess skin than normal. For them, it may be necessary to make two long scars. One horizontal, and one vertical. This is called "Fleur de Lys abdominoplasty".
As you can see, there is no single abdominoplasty scar suitable for everyone. The horizontal scar may be longer or shorter, and may have another vertical scar added to it.
The horizontal scar is usually placed about 4-6 cm from the pubis. In patients with more laxity we can place the scar lower (to camouflage it with the underwear).
Evolution of the scars after abdominoplasty
The evolution of the scars is divided into three stages from the time it begins to close until its complete maturation. It should be noted that the minimum time for it to stabilize is nine months, in some cases it takes longer than that.
During this time a series of changes are observed in the scars that include changes in color, increased thickness, among others. But little by little they will progress until they take their best appearance.
The first stage of evolution is closure, which takes three to four weeks. This begins after the incision is made, at which time the body begins to produce collagen to fill the wound.
Next, the establishment phase begins, which is characterized by increased blood flow and collagen accumulation in the wound area. This causes the scar to become darker and thicker. It can take up to six months.
Finally, maturation occurs when collagen formation and blood flow are reduced. This means that the skin has replaced itself. At this point the scar becomes less visible, thinner and lighter. However, it does not completely disappear. Maturation can last up to two years after surgery.
What to do to remove the abdominoplasty scar?
The first step to disguise the scar of an abdominoplasty begins in the consultation. When we evaluate you, we consider how to make the scar so that it can be seen as little as possible. We design a line with the least extension and as low as possible. In the operating room, we suture with precision to achieve the best result. High quality threads, suture in several layers, and a meticulous technique allow us to hide it better.
For better healing, it is recommended that you wax the pubic area a few weeks before surgery. It will avoid hair-related problems. It will also be good for you to stop smoking. The first months of postoperative abdominoplasty, it is essential to avoid complications of the wound.
Following all the surgeon's recommendations accelerates recovery and avoids problems. Avoiding infections and wound openings will improve the abdominoplasty scar.
How to keep the scar clean?
The first 3 months it is enough to keep the wound clean. It is washed once a day with warm water and neutral soap. Subsequently, it is covered with sterile plasters.
It is important to do this washing gently, without rubbing hard, as the wound is fresh. Keeping the scar clean and dry will avoid the risk of infection.
How to keep the scar moisturized?
Weeks later, you can start applying ointments. There are many types of creams, which we will talk about later. Moisturizing during this time is essential for the scar to heal properly. Apply the cream or gel recommended by the doctor twice a day, or according to his instructions, with soft massages.
If the scar looks very raised, you can place trofolastin sheets on top of it. They are water resistant and can last up to 5-7 days without replacement. This treatment usually lasts for 4-5 months.
Patience is also an important aspect. You should know that the abdominoplasty scar takes between 1 and 2 years to "mature". This means that the first few months it will be somewhat elevated and more reddish in color. Over time, it will flatten and take on a lighter color.
How to protect the scar from sunlight?
During this time it is essential that you avoid sun exposure to the scar. The sun pigments these wounds too much. Therefore, you should protect them from the sun for about 2 years. If you are going to be outdoors, apply sunscreen, with SPF of at least 30, every two hours on the wound.
After two years, the scar stabilizes. After this period, it is unlikely to improve. If at that time, you are unhappy with the result, other treatments can be considered. Laser therapy, corticosteroid infiltration, or further surgery to "reshape the scar" are options to consider with your surgeon.
Check-ups with your doctor are essential for a good evolution. They are also effective in detecting early problems in your abdominoplasty scar.
Occasionally, the scars may widen, forming keloids or hypertrophic scars. These complications will be evaluated during follow-up in our clinic. These problems are easily solved (corticosteroid infiltration, trofolastin sheets).
Scar improvement treatments
Whenever there is a cut in the skin will form a scar and this does not disappear completely. In an abdominoplasty the scar is large, the advantage is that it can be concealed with underwear, as it is located in the lower abdomen.
Still, if the patient is concerned about how the scar looks, there are some treatments that help improve its appearance:
- Application of rosehip creams: Rosehip is one of the most recommended natural ingredients, along with aloe vera gel, to help heal scars. It helps reduce inflammation and redness during healing.
- Use silicone sheeting: in addition to protecting the wound, it prevents too much collagen from being produced and, therefore, a very large scar from forming.
- Laser treatment: is applied to reduce the size, color and visibility of scars. However, it is not for all types of scars or skin, so consult your doctor if this treatment is feasible.
- Skin grafting: involves transferring skin from another part of the body to the scar area.
These are some common treatments to reduce the visibility of scars. When these fail there is another alternative which is surgical correction, which is usually applied in prominent scars.
How to massage the abdominoplasty scar?
Massaging an abdominoplasty scar can help decrease abdominal adhesions. This means that it will help the mark not to become sunken, but to heal properly.
However, you should not be in a hurry to start these massages. Starting to mobilize the scar too early can cause problems. It can facilitate fluid accumulation (seromas), or cause the wound to open up (dehiscence).
Therefore, your surgeon gives you permission to begin massage when the scar shows adequate signs of healing. This usually takes about two to three weeks to occur.
We usually recommend drainage sessions with professional masseurs. They can guide you and teach you how to massage. With moisturizing cream, pressing gently on the scar, circular movements are usually made around the entire wound. This should be done once or twice a day.
What is the best abdominoplasty scar cream?
There are a multitude of opinions on this subject. We do not have an exact answer, but we can provide our experience. From about the third month after surgery, we usually recommend a daily application of Cicalfate. It is a disinfectant and regenerating cream. At the same time, it helps to soothe the discomfort and itching that can be caused by the abdominoplasty scar.
In addition, this cream is appropriate and well tolerated by many skin types. Cicalfate is useful for both light-skinned and dark-skinned patients.
When you have surgery such as abdominoplasty or a breast lift in Madrid Spain, the surgeon will give you recommendations to take care of the scars.
How long does it take for the skin to reattach after abdominoplasty?
Abdominoplasty is an operation that works on large areas of the body. To achieve the final silhouette, several months must pass. During this time, the skin will adapt until the desired contour is achieved.
However, the first 3-4 weeks are essential for skin adhesion. Too much mobilization of the abdominoplasty scar, with massage, exercise, is very likely to cause problems. The main problem would be seroma, which is the accumulation of fluid under the skin that usually needs to be drained.
Thus, it is advisable not to exert too much friction on the wound during the first month after surgery. After this time, the abdominoplasty scar can begin to be massaged very safely.
How long does it take for a tummy tuck scar to fade?
Scars are never completely "erased" from our body. However, the abdominoplasty scar may end up being almost invisible. Its evolution depends on many factors, which we have already explained (genetics, individual care, surgical technique...).
The first 3 or 4 months after surgery, the scar is usually tight and reddened. Most commonly, after that time, it will slowly improve. You must be patient, because it can take up to two years to lighten.
After these two years, the abdominoplasty scar will not undergo major changes. Even so, it may improve discreetly with the passage of time. However, the main improvements occur between 3 and 24 months postoperatively.
